EP1135139B1 - Micronized eplerenone compositions - Google Patents
Micronized eplerenone compositions Download PDFInfo
- Publication number
- EP1135139B1 EP1135139B1 EP99963052A EP99963052A EP1135139B1 EP 1135139 B1 EP1135139 B1 EP 1135139B1 EP 99963052 A EP99963052 A EP 99963052A EP 99963052 A EP99963052 A EP 99963052A EP 1135139 B1 EP1135139 B1 EP 1135139B1
- Authority
- EP
- European Patent Office
- Prior art keywords
- eplerenone
- pharmaceutical composition
- weight percent
- composition according
- tablet
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
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- A61K31/58—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
- A61K31/585—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin containing lactone rings, e.g. oxandrolone, bufalin
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- A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
- A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches
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- A61K9/2022—Organic macromolecular compounds
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- A61P9/12—Antihypertensives
Definitions
- the present invention relates to pharmaceutical compositions comprising the compound eplerenone as an active ingredient, and more particularly to pharmaceutical compositions containing micronized eplerenone and the use of such compositions in the manufacture of medicaments.
- Eplerenone corresponds in structure to Formula I, below: Spironolactone, another 20-spiroxane-steroid having activity as an aldosterone antagonist, is commercially available for the treatment of hypertension.
- Spironolactone corresponds in structure to Formula II, below: Spironolactone, however, exhibits antiandrogenic activity that can result in gynecomastia and impotence in men, and weak progestational activity that produces menstrual irregularities in women.
- spironolactone sold under the name AldactoneTM
- spironolactone contains 25, 50 or 100 mg doses of spironolactone in a matrix comprising, among other carrier materials, calcium sulfate dihydrate as a diluent, maize starch as a disintegrant, povidone K-30 as a binding agent, magnesium stearate as a lubricant, and flavor, colorant, and coating ingredients that include hydroxypropyl methylcellulose and polyethylene glycol 400.
- compositions comprising micronized eplerenone and a pharmaceutically acceptable carrier material, however, have been discovered that can effectively deliver a therapeutically preferred amount of the compound to the subject.
- unique combinations of carrier material with the micronized eplerenone have been found that provide still better solubilization characteristics.
- These combinations of active compound and carrier material have been found to possess improved bioavailability, chemical stability, physical stability, dissolution. profiles, disintegration times, safety, as well as other improved pharmacokinetic, chemical and/or physical properties.
- the present invention comprises these pharmaceutical compositions, unit dosage forms based thereon, and methods for the preparation and use of both.
- Fig. 1 shown in two portions as Fig. 1A and 1B, is a schematic diagram of a manufacturing process for a composition of this invention.
- compositions comprising micronized eplerenone as the active ingredient in a daily dosage amount 10 mg to 1000 mg along with a pharmaceutically acceptable carrier material are unique compositions exhibiting superior performance as aldosterone receptor blockers. Such pharmaceutical compositions exhibit superior activity, potency, safety and therapeutic effectiveness at this dosage range. These compositions provide eplerenone to a patient at a dosage that is sufficient to provide prolonged blocking of aldosterone receptors and thus confer the desired therapeutic benefit, while maintaining a safe clearance time. Undesirable side effects such as, but not limited to, gastrointestinal irritation, antiandrogenic and progestational activity are also minimized with the pharmaceutical compositions of the present invention.
- compositions are advantageously used to block aldosterone receptors and, among other pharmacological actions, can increase sodium and water excretion with a concomitant potassium-sparing effect.
- Such compositions can be specifically employed for the prophylaxis and treatment of cardiovascular diseases such as heart failure; hypertension (especially the management of mild to moderate hypertension); edema associated with liver insufficiency; post-myocardial infarction; cirrhosis of the liver; stroke prevention; and reduction of heart rate for subjects exhibiting an accelerated heart rate.
- cardiovascular diseases such as heart failure; hypertension (especially the management of mild to moderate hypertension); edema associated with liver insufficiency; post-myocardial infarction; cirrhosis of the liver; stroke prevention; and reduction of heart rate for subjects exhibiting an accelerated heart rate.
- These pharmaceutical compositions exhibit, among other features, (i) improved selectivity for aldosterone receptors, (ii) reduced binding affinity to the progesterone and androgen receptor,
- compositions are also useful for veterinary treatment of companion animals, exotic animals and farm animals, including mammals, rodents and the like. More preferred non-human animals include horses, dogs, and cats.
- the pharmaceutical compositions of the present invention provide these dosage forms and exhibit one or more superior properties relative to unformulated eplerenone and/or other compositions comprising eplerenone. These superior properties include, but are not limited to, one or more of the following:
- Eplerenone particles having a D 90 particle size of 25 to 400 microns are referred to herein as micronized eplerenone or micronized eplerenone particles.
- the D 90 particle size (that is, the particle size of at least 90% of the particles) of the eplerenone used as a starting material in the composition is less than 400 microns, preferably less than 200 microns, more preferably less than 150 microns, still more preferably less than 100 microns, and still more preferably less than 90 microns.
- a particularly preferred D 90 particle size is 30 to . 110 microns, and more particularly still 30 to 50 microns.
- a particularly preferred D 90 particle size is 50 to 150 microns, and more preferably 75 to 125 microns.
- Micronized eplerenone so sized also typically exhibits a D 10 particle size of less than 10 microns. For example, as illustrated in Example 30, reducing the D 90 particle size of the starting material eplerenone from 220 microns to 90 microns can materially improve the bioavailability of the pharmaceutical composition.
- compositions of the present invention comprise micronized eplerenone in an amount of 10 mg to 1000 mg.
- pharmaceutical compositions comprise micronized eplerenone in an amount of 20 mg to 400 mg, more preferably from 25 mg to 200 mg, and still more preferably from 25 mg to 150 mg.
- compositions of the present invention are useful where administration of an aldosterone receptor blocker is indicated. It has been found that these compositions are particularly effective in the treatment of cardiovascular diseases such as heart failure; hypertension (especially the management of mild to moderate hypertension); edema associated with liver insufficiency; post-myocardial infarction; cirrhosis of the liver; stroke prevention; and reduction of heart rate for subjects exhibiting an accelerated heart rate.
- cardiovascular diseases such as heart failure; hypertension (especially the management of mild to moderate hypertension); edema associated with liver insufficiency; post-myocardial infarction; cirrhosis of the liver; stroke prevention; and reduction of heart rate for subjects exhibiting an accelerated heart rate.
- the pharmaceutical composition preferably provides a daily dosage of eplerenone in the amount of 25 mg to 200 mg, more preferably 25 mg to 75 mg, and still more preferably 50 mg.
- a daily dose of 0.33 to 2.67 mg/kg body weight (based upon an average body weight of about 75 kg), preferably between 0.33 and 1.00 mg/kg body weight and most preferably 0.67 mg/kg body weight, may be appropriate.
- the daily dose can be administered in one to four doses per day, preferably one dose per day.
- the pharmaceutical composition preferably provides a daily dosage of eplerenone in the amount of 50 mg to 300 mg, more preferably 50 mg to 150 mg, and still more preferably 100 mg.
- the daily dose can be administered in one to four doses per day, preferably one dose per day.
- the pharmaceutical composition preferably provides a daily dosage of eplerenone in the amount of 50 mg to 500 mg, more preferably 100 mg to 400 mg, and still more preferably 300 mg.
- the daily dose can be administered in one to four doses per day, preferably one dose per day.
- compositions of the present invention provide a therapeutic effect as aldosterone receptor blockers in humans over an interval of about 12 to 24 hours, preferably about 24 hours, after oral administration.
- the pharmaceutical compositions of the present invention provide a daily dosage of eplerenone sufficient to cause an increase in blood serum renin and aldosterone concentrations in humans over an interval of about 12 to 24 hours, preferably about 24 hours, after oral administration.
- these compositions provide a daily dosage of eplerenone sufficient to cause an average increase in blood serum renin concentration over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 10%.
- these compositions provide a daily dosage of eplerenone sufficient to cause an average increase in blood serum aldosterone concentrations over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 50%.
- compositions of the present invention provide a daily dosage of eplerenone sufficient to cause an average increase in the urinary log 10 (sodium/potassium) ratio in humans over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition.
- compositions of the present invention provide a daily dosage of eplerenone sufficient to cause an average decrease in diasystolic blood pressure in humans over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 5%.
- Dosage unit forms of the pharmaceutical compositions can typically contain, for example, 10, 20, 25, 37.5, 50, 75, 100, 125, 150, 175, 200, 250, 300, 350 or 400 mg of eplerenone.
- Preferred dosage unit forms contain 25, 50, 100, or 150 mg of micronized eplerenone.
- the dosage unit form can be selected to accommodate the desired frequency of administration used to achieve the specified daily dosage.
- the amount of the unit dosage form of the pharmaceutical composition that is administered and the dosage regimen for treating the condition or disorder depends on a variety of factors, including the age, weight, sex and medical condition of the subject, the severity of the condition or disorder, the route and frequency of administration, and thus can vary widely, as is well known.
- compositions of the present invention deliver an amount of eplerenone sufficient to inhibit a protracted genomic response caused by aldosterone binding to the aldosterone receptor site. Interruption of aldosterone binding by eplerenone prevents aldosterone-induced gene product synthesis resulting in an extended period of functional aldosterone receptor blockade that does not require a sustained plasma eplerenone concentration. Accordingly, once-a-day administration is preferred for such tablets for convenience of administration.
- the eplerenone of the novel pharmaceutical compositions of the present invention can be prepared using the methods set forth in Grob et al., U.S. Patent 4,559,332 and Ng et al., WO 98/25948, particularly scheme 1 set forth in Ng. et al., WO 98/25948.
- compositions of the present invention comprise micronized eplerenone in association with one or more non-toxic, pharmaceutically-acceptable carriers, excipients and/or adjuvants (collectively referred to. herein as "carrier materials").
- carrier materials are acceptable in the sense of being compatible with the other ingredients of the composition and are not deleterious to the recipient.
- the pharmaceutical compositions of the present invention can be adapted for administration by any suitable route by selection of appropriate carrier materials and a dosage of eplerenone effective for the treatment intended.
- these compositions can be prepared in a form suitable for administration orally, intravascularly, intraperitoneally, subcutaneously, intramuscularly (IM) or rectally.
- the carrier material employed can be a solid or a liquid, or both, and is preferably formulated with the compound as a unit-dose composition, for example, a tablet, which can contain from 1% to 95%, preferably 10% to 75%, more preferably 20% to 60%, and still more preferably 20% to 40%, by weight of micronized eplerenone.
- a tablet which can contain from 1% to 95%, preferably 10% to 75%, more preferably 20% to 60%, and still more preferably 20% to 40%, by weight of micronized eplerenone.
- Such pharmaceutical compositions of the invention can be prepared by any of the well known techniques of pharmacy, consisting essentially of admixing the components.
- the pharmaceutical composition can contain a desired amount of micronized eplerenone and be in the form of, for example, a tablet, a hard or soft capsule, a lozenge, a cachet, a dispensable powder, granules, a suspension, an elixir, a liquid, or any other form reasonably adapted for oral administration.
- a pharmaceutical composition is preferably made in the form of a discrete dosage unit containing a predetermined amount of eplerenone, such as tablets or capsules.
- Such oral dosage forms can further comprise, for example, buffering agents. Tablets, pills and the like additionally can be prepared with enteric coatings. Unit dosage tablets or capsules are preferred.
- compositions suitable for buccal (sub-lingual) administration include, for example, lozenges comprising eplerenone in a flavored base, such as sucrose, and acacia or tragacanth, and pastilles comprising eplerenone in an inert base such as gelatin and glycerin or sucrose and acacia.
- Liquid dosage forms for oral administration can include pharmaceutically acceptable emulsions, solutions, suspensions, syrups, and elixirs containing inert diluents commonly used in the art, such as water.
- Such compositions can also comprise, for example, wetting agents, emulsifying and suspending agents, and sweetening, flavoring, and perfuming agents.
- suitable liquid dosage forms include, but are not limited, aqueous solutions comprising eplerenone and ⁇ -cyclodextrin or a water soluble derivative of ⁇ -cyclodextrin such as sulfobutyl ether ⁇ -cyclodextrin; heptakis-2,6-di-O-methyl- ⁇ -cyclodextrin; hydroxypropyl- ⁇ -cyclodextrin; and dimethyl- ⁇ -cyclodextrin.
- aqueous solutions comprising eplerenone and ⁇ -cyclodextrin or a water soluble derivative of ⁇ -cyclodextrin such as sulfobutyl ether ⁇ -cyclodextrin; heptakis-2,6-di-O-methyl- ⁇ -cyclodextrin; hydroxypropyl- ⁇ -cyclodextrin; and dimethyl- ⁇ -cyclodextrin.
- compositions of the present invention can also be administered by injection (intravenous, intramuscular, subcutaneous or jet).
- injectable compositions can employ, for example, saline, dextrose, or water as a suitable carrier material.
- the pH value of the composition can be adjusted, if necessary, with suitable acid, base, or buffer.
- suitable bulking, dispersing, wetting or suspending agents including mannitol and polyethylene glycol (such as PEG 400), can also be included in the composition.
- a suitable parenteral composition can also include eplerenone in injection vials.
- Aqueous solutions can be added to dissolve the composition prior to injection.
- compositions can be administered in the form of a suppository or the like.
- rectal formulations preferably contain micronized eplerenone in a total amount of, for example, 0.075 to 30% w/w, preferably 0.2 to 20% w/w and most preferably 0.4 to 15% w/w.
- Carrier materials such as cocoa butter, theobroma oil, and other oil and polyethylene glycol suppository bases can be used in such compositions.
- Other carrier materials such as coatings (for example, hydroxypropyl methylcellulose film coating) and disintegrants (for example, croscarmellose sodium and cross-linked povidone) can also be employed if desired.
- these pharmaceutical compositions can be prepared by any suitable method of pharmacy which includes the step of bringing into association eplerenone and the carrier material or carriers materials.
- the compositions are prepared by uniformly and intimately admixing the active compound with a liquid or finely divided solid carrier, or both, and then, if necessary, shaping the product.
- a tablet can be prepared by compressing or molding a powder or granules of the compound, optionally with one or more accessory ingredients.
- Compressed tablets can be prepared by compressing, in a suitable machine, the compound in a free-flowing form, such as a powder or granules optionally mixed with a binding agent, lubricant, inert diluent and/or surface active/dispersing agent(s). Molded tablets can be made by molding, in a suitable machine, the powdered compound moistened with an inert liquid diluent.
- the pharmaceutical compositions of the present invention comprise micronized eplerenone in a desired amount in combination with one or more pharmaceutically-acceptable carrier materials appropriate to the indicated route of administration.
- Oral dosage forms of the pharmaceutical compositions of the present invention preferably comprise micronized eplerenone in a desired amount admixed with one or more carrier materials selected from the group consisting of diluents, disintegrants, binding agents and adhesives, wetting agents, lubricants, anti-adherent agents and/or other carrier materials. More preferably, such compositions are tableted or encapsulated for convenient administration.
- Such capsules or tablets can be in the form of immediate release capsules or tablets, or can contain a controlled-release formulation as can be provided, for example, in a dispersion of eplerenone in hydroxypropyl methylcellulose.
- Injectable dosage forms preferably are adapted for parenteral injection.
- these dosage forms comprise micronized eplerenone in aqueous or non-aqueous isotonic sterile injection solutions or suspensions, such as eplerenone suspended or dissolved in water, polyethylene glycol, propylene glycol, ethanol, corn oil, cottonseed oil, peanut oil, sesame oil, benzyl alcohol, sodium chloride, and/or various buffers.
- These solutions and suspensions can be prepared from sterile powders or granules having one or more of the carriers or diluents mentioned for use in the formulations for oral administration.
- compositions of the present invention provides compositions exhibiting improved performance with respect to, among other properties, efficacy, bioavailability, clearance times, stability, compatibility of eplerenone and carrier materials, safety, dissolution profile, disintegration profile and/or other pharmacokinetic, chemical and/or physical properties.
- the carrier materials preferably are water soluble or water dispersible and have wetting properties to offset the low aqueous solubility and hydrophobicity of eplerenone.
- the combination of carrier materials selected provides tablets that can exhibit, among other properties, improved dissolution and disintegration profiles, hardness, crushing strength, and/or friability.
- compositions of the present invention optionally can comprise one or more diluents as a carrier material.
- Suitable diluents can include, either individually or in combination, such diluents as lactose USP; lactose USP, anhydrous; lactose USP, spray dried; starch USP; directly compressible starch; mannitol USP; sorbitol; dextrose monohydrate; microcrystalline cellulose NF; dibasic calcium phosphate dihydrate NF; sucrose-based diluents; confectioner's sugar; monobasic calcium sulfate monohydrate; calcium sulfate dihydrate NF; calcium lactate trihydrate granular NF; dextrates NF (e.g., EmdexTM); CelutabTM; dextrose (e.g., CereloseTM); inositol; hydrolyzed cereal solids such as the MaltronsTM and Mor-RexTM; amylose; Rexcel
- the present pharmaceutical compositions comprise one or more diluents in the range of 5% to 99%, preferably 25% to 90%, and more preferably 40% to 80%, of the total weight of the composition.
- the diluent or diluents selected preferably exhibit suitable compressibility and pre-compression flow properties.
- Microcrystalline cellulose e.g. Avicel® PH 101
- lactose either individually or in combination (both diluents are present) are preferred diluents. Both diluents are chemically compatible with micronized eplerenone.
- extragranular microcrystalline cellulose that is, microcrystalline cellulose added to a wet granulated composition after the drying step
- intragranular microcrystalline cellulose that is, microcrystalline cellulose added to the composition during or before the wet granulation step
- Lactose especially lactose monohydrate, is particularly preferred. Lactose typically provides pharmaceutical compositions having suitable eplerenone release rates, stability, pre-compression flowability, and drying properties at a relatively low diluent cost.
- compositions of the present invention can comprise one or more disintegrants as a carrier material, particularly for tablet formulations.
- Suitable disintegrants can include, either individually or in combination, such disintegrants as starches; sodium starch glycolate; clays (such as VeegumTM HV); celluloses (such as purified cellulose, methylcellulose and sodium carboxymethylcellulose, and carboxymethylcellulose); alginates; pregelatinized corn starches (such as NationalTM 1551 and NationalTM 1550); crospovidone USP NF; gums (such as agar, guar, locust bean, KarayaTM, pectin, and tragacanth).
- Disintegrants can be added at any suitable step during the preparation of the pharmaceutical composition, particularly prior to granulation or during the lubrication step prior to compression.
- the present pharmaceutical compositions comprise one or more disintegrants in the range of 0.5% to 30%, preferably , 1% to 10%, and more preferably 2% to 6%, of the total weight of the composition.
- Croscarmellose sodium is a preferred disintegrant for tablet formulations, preferably in the range of 1% to 10%, preferably 2% to 6%, and more preferably 5%, by weight of the composition.
- compositions of the present invention optionally can comprise one or more binding agents or adhesives as a carrier material.
- binding agents and adhesives preferably impart sufficient cohesion to the powders to permit normal processing such as sizing, lubrication, compression and packaging, but still permit the tablet to disintegrate and the composition to dissolve upon ingestion.
- Suitable binding agents and adhesives include, either individually or in combination, such binding agents and adhesives as acacia; tragacanth; sucrose;-gelatin; glucose; starch; cellulose materials such as, but not limited to, methylcellulose and sodium carboxymethylcellulose (e.g., TyloseTM); alginic acid and salts of alginic acid; magnesium aluminum silicate; polyethylene glycol; guar gum; polysaccharide acids; bentonites; polyvinylpyrrolidone (povidone) ; polymethacrylates; hydroxypropyl methylcellulose (HPMC) ; hydroxypropyl cellulose (KlucelTM); ethyl cellulose (EthocelTM); pregelatinized starch (.such as NationalTM 1511 and Starch 1500).
- the present pharmaceutical compositions comprise one or more binding agents and/or adhesives in the range of 0.5% to 25%, preferably 0.75% to 15%, and more preferably 1% to 10%, of the total weight of the composition.
- Hydroxypropyl methylcellulose is a preferred binding agent used impart cohesive properties to the powder blend of the eplerenone formulation.
- the compositions preferably comprise hydroxypropyl methylcellulose as a binding agent in a range of 0.5% to 10%, more preferably 1% to 8%, and still more preferably 2% to 4%, of the total weight of the composition.
- Low molecular weight hydroxypropyl methylcellulose having a viscosity of 2 cps to 8 cps typically can be used, although viscosities of 2 cps to 6 cps are preferred, particularly viscosities of 2 cps to 4 cps. Viscosities are measured as a 2 percent solution in water at 20°C.
- Methoxy content of the hydroxypropyl methylcellulose typically is 15% to 35%, whereas hydroxypropyl content is typically up to 15%, preferably 2% to 12%.
- the pharmaceutical compositions of the present invention optionally can comprise one or more wetting agents as a carrier material, particularly for tablet formulations.
- Such wetting agents preferably maintain eplerenone in solution and improve the bioavailability of the pharmaceutical composition.
- Suitable wetting agents include, either individually or in combination, such wetting agents as oleic acid; glyceryl monostearate; sorbitan monooleate; sorbitan monolaurate; triethanolamine oleate; polyoxyethylene sorbitan mono-oleate; polyoxyethylene sorbitan monolaurate; sodium oleate; and sodium lauryl sulfate.
- Wetting agents that are anionic surfactants are preferred.
- the present pharmaceutical compositions comprise one or more wetting agents present at 0.1% to 15%, preferably 0.25% to 10%, and more preferably 0.5% to 5%, of the total weight of the composition.
- compositions of the present invention preferably comprise sodium lauryl sulfate as the wetting agent at 0.25% to 7%, more preferably 0.4% to 4%, and still more preferably 0.5 to 2%, of the total weight of the composition.
- the pharmaceutical compositions of the present invention optionally comprises one or more lubricants and/or glidants as a carrier material.
- Suitable lubricants and/or glidants include, either individually or in combination, such lubricants and/or glidants as glyceryl behenate (CompritolTM 888); metalllic stearates (e.g., magnesium, calcium and sodium stearates); stearic acid; hydrogenated vegetable oils (e.g., SterotexTM); talc; waxes; StearowetTM; boric acid; sodium benzoate and sodium acetate; sodium chloride; DL-Leucine; polyethylene glycols (e.g., CarbowaxTM 4000 and CarbowaxTM:6000); sodium oleate; sodium benzoate; sodium acetate; sodium lauryl sulfate; sodium stearyl fumarate (PruvTM); and magnesium lauryl sulfate.
- Magnesium stearate is a preferred lubricant used to reduce friction between the equipment and granulation during compression.
- the pharmaceutical compositions of the present invention optionally can comprise one or more anti-adherent agents or glidants as a carrier material.
- Suitable anti-adherents or glidants include, either individually or in combination, such anti-adherents as talc, cornstarch, Cab-O-SilTM, SyloidTM, DL-Leucine, sodium lauryl sulfate, and metallic stearates.
- the present pharmaceutical compositions comprise one or more anti-adherents or glidants at 0.1% to 15%, preferably 0.25% to 10%, and more preferably 0.5% to 5%, of the total weight of the composition.
- Talc is a preferred anti-adherent or glidant agent used to reduce formulation sticking to equipment surfaces and also to reduce static in the blend.
- the compositions preferably comprise talc at 0.1% to 10%, more preferably 0.25% to 5%, and still more preferably 0.5% to 2%, of the total weight of the composition.
- compositions of the present invention can be used in the preparation of the pharmaceutical compositions of the present invention. Tablets can be coated or uncoated.
- the pharmaceutical compositions comprise micronized eplerenone in a desired amount and one or more cellulosic carrier materials.
- cellulosic carrier materials embraces carrier materials comprising cellulose or a cellulose derivative such as purified cellulose; microcrystalline cellulose; and alkyl celluloses and their derivatives and salts (e.g., methylcellulose, sodium carboxymethyl-cellulose, carboxymethylcellulose, croscarmellose sodium, hydroxypropyl cellulose, hydroxypropyl methylcellulose and the like).
- at least one carrier material is a cellulosic material selected from the group consisting of C 1 -C 6 -alkyl celluloses and their derivatives and salts.
- this cellulosic material is selected from the group consisting of hydroxyalkyl alkylcelluloses and their derivatives and salts. Still more preferably, this celiulosic material is selected from the group consisting of hydroxy(C 2 -C 4 -alkyl) (C 1 -C 4 -alkyl)celluloses and their derivatives and salts.
- compositions comprising micronized eplerenone in a desired amount and one or more cellulosic carrier materials preferably further comprise one or more carrier materials selected from the group consisting of diluents, disintegrants, binding agents, wetting agents, lubricants and anti-adherent agents. More preferably, these pharmaceutical compositions comprise one or more carrier materials selected from the group consisting of lactose, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, magnesium stearate, and talc. Still more preferably, these pharmaceutical compositions comprise lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, and hydroxypropyl methylcellulose. Still more preferably, these pharmaceutical compositions further comprise one or more of the carrier materials sodium lauryl sulfate, magnesium stearate, and talc.
- the individual pharmaceutically acceptable carrier materials described in the above embodiment optionally can be replaced with other suitable carrier materials if desired.
- Acceptable substitute carrier materials are chemically compatible both with eplerenone and with the other carrier materials.
- other diluents, disintegrants, binding agents and adhesives, wetting agents, lubricants and/or anti-adherent or glidant agents can be employed, it has been discovered, however, that the pharmaceutical compositions comprising micronized eplerenone, lactose, microcrystalline cellulose, croscarmellose sodium, and hydroxypropyl methylcellulose, and, optionally, sodium lauryl sulfate, magnesium stearate, and/or talc possess a superior combination of pharmacokinetic, chemical and/or physical properties relative to such other compositions.
- the pharmaceutical composition comprises:
- weight percent means the weight percent of a specified ingredient based upon the total weight of all ingredients of the composition.
- the pharmaceutical composition comprises micronized eplerenone and a cellulosic carrier material wherein the compositions are in oral dosage form, preferably tablets or capsules.
- the composition further comprises one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions are in the form of unit dosage tablets or capsules.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials in the form of an oral unit dosage suitable for once-a-day or twice-a-day oral administration. Still more preferably, these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials that when orally administered to a human patient in need thereof provide a therapeutic effect as an aldosterone receptor blocker over an interval of about 12 to about 24 hours, preferably at least about 24 hours, after oral administration.
- these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials that when orally administered to a human patient in need thereof cause an average increase in blood serum renin concentration over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 10%.
- these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials that when orally administered to a human patient in need thereof cause an average increase in blood serum aldosterone concentration over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 50%.
- these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials that when orally administered to a human patient in need thereof cause an average decrease in diastolic blood pressure over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition of at least about 5%.
- these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials that when orally administered to a human patient in need thereof cause an average increase in the urinary log 10 (sodium/potassium) ratio over an interval of about 12 to 24 hours, preferably about 24 hours, after ingestion of the composition.
- these pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the composition be present in the amounts or the weight fractions set forth below.
- Oral delivery of the pharmaceutical compositions of the present invention can include immediate release compositions as well as controlled release compositions.
- the pharmaceutical compositions are in the form of immediate release tablets or capsules.
- the immediate release compositions comprise micronized eplerenone in an amount sufficient to provide the desired daily dosage of eplerenone, that is; an amount of 10 mg to 1000 mg, more preferably an amount of 20 mg to 400 mg, still more preferably an amount of 25 mg to 200 mg, still more preferably an amount of 25 mg to 150 mg, and still more preferably an amount of 50 mg to 100 mg.
- a once-a-day immediate release tablet or capsule contains eplerenone in an amount, for example, of
- the same batch can be used to prepare tablets (or capsules) of different strengths by compressing the formulation in different tablet sizes (or encapsulating the formulation in different capsule sizes or using different capsule fill weights).
- the amount of eplerenone in such novel compositions preferably is within the ranges previously discussed, the formulations also can be useful for the administration of an amount of eplerenone falling outside of the disclosed dosage ranges.
- compositions of the present invention preferably are immediate release compositions from which about 50% of the micronized eplerenone is dissolved in vitro within about 15 minutes, more preferably at least about 80% of the eplerenone eplerenone is dissolved in vitro within about 30 minutes, and still more preferably at least about 90% of the eplerenone is dissolved in vitro within about 45 minutes using 1% sodium dodecyl sulfate (SDS) in water as the dissolution medium at 37°C in the dissolution assay discussed hereinafter.
- SDS sodium dodecyl sulfate
- 0.1 N HCl in water at 37°C is the in vitro dissolution medium in that assay, and about 50% of the micronized eplerenone is dissolved in about 20 minutes, about 80% is dissolved at about 45 minutes and greater than about 90% is dissolved in about 90 minutes. More preferably, about 50% of the micronized eplerenone is dissolved in about 15 minutes, about 80% is dissolved at about 30 minutes and about 90% or more is dissolved in about 45 minutes.
- Carrier materials for immediate release compositions preferably are selected to provide a disintegration time less than 30 minutes, preferably 20 minutes or less, more preferably 18 minutes or less, and still more preferably 14 minutes or less.
- compositions of the present invention can be prepared, for example, by direct encapsulation or direct compression, they preferably are wet granulated prior to encapsulation or compression.
- Wet granulation densifies the compositions resulting in improved flow properties, improved compression characteristics and easier metering or weight dispensing of the final compositions.
- the average particle size of the granulation preferably permits for convenient handling and processing and, for tablets, permits the formation of a directly compressible mixture that forms pharmaceutically acceptable tablets.
- the desired tap and bulk densities of the granulation are normally 0.3 g/ml to, 1.0 g/ml, preferably 0.4 g/ml to 0.8 g/ml.
- the pharmaceutical composition in an amount sufficient to make a uniform batch of tablets is subjected to tableting in a conventional production scale tableting machine at normal compression pressure (for example, about 1 kN to about 50 kN).
- a conventional production scale tableting machine at normal compression pressure (for example, about 1 kN to about 50 kN).
- Any tablet hardness convenient with respect to handling, manufacture, storage and ingestion may be employed. Hardness in the range of 3.5 kP to 22 kP is typically acceptable, with 3.5 kP to 9 kP preferred for 25 mg tablets, 5 kP to 13 kP preferred for 50 mg tablets, and 8 kP to 22 kP preferred for 100 mg tablets.
- the mixture however, is not be compressed to such a degree that there is subsequent difficulty in achieving hydration when exposed to gastric fluid.
- tablet friability preferably is less than 0.8%, more preferably less than 0.4%.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 1 to 10 weight percent of croscarmellose sodium; 0.1 to 7 weight percent of sodium lauryl sulfate; 0.1 to 10 weight percent of talc; and/or 0.1 to 10 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.1 to 7 weight percent of sodium lauryl sulfate; 0.1 to 10 weight percent of talc; and 0.1 to 10 weight percent of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from 2 cps to 8 cps, more preferably 2 cps to 6 cps, as noted before.
- the compositions are preferably in the form of unit dosage tablets.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.25 to 4 weight percent of sodium lauryl sulfate; 0.1 to 5 weight percent of talc; and 0.25 to 5 weight percent of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from 2 cps to 6 cps, as before.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 to 1.5 weight;percent of sodium lauryl sulfate; 0.5 to 1.5 weight percent of talc; and 0.25 to 0.75 weight percent of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from 2 cps to 4 cps, as before.
- compositions of this embodiment are in the form of a coated or uncoated unit dosage tablet wherein the uncoated tablet or the coated tablet prior to coating comprise:
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 1 mg to 25 mg of croscarmellose sodium; 0.25 mg to 5 mg of sodium lauryl sulfate; 0.5 mg to 5 mg of talc; and 0.5 mg to 3 mg of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from about 2 cps to about 8 cps, more preferably 2 cps to 6 cps, as discussed before.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.25 mg to 1.5 mg of sodium lauryl sulfate; 0.25 mg to 1.5 mg of talc; and 0.1 mg to 1 mg of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from 2 cps to 6 cps, as before.
- the compositions are preferably in the form of unit dosage tablets.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 1 to 2.5 mg of sodium lauryl sulfate; 1 to 2.5 mg of talc; and 0.5 mg to 1.5 mg of magnesium stearate.
- the hydroxypropyl methylcellulose has a viscosity of from 2 cps to 6 cps, as before.
- the compositions are preferably in the form of unit dosage tablets.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 3 mg to 4 mg of sodium lauryl sulfate; 3 mg to 4 mg of talc; and 1 mg to 2 mg of magnesium stearate.
- the hydroxypropyl metbylcellulose has a viscosity of from 2 cps to 6 cps, as before.
- the compositions are preferably in the form of unit dosage tablets.
- compositions of this embodiment comprise lactose, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate.
- the pharmaceutical compositions release in vitro at least 50% of the eplerenone contained in the composition within about 15 minutes in the SDS-containing medium. More preferably, about 50% of the micronized eplerenone is dissolved in about 20 minutes, about 80% is dissolved in about 45 minutes and greater than about 90% is dissolved in about 90 minutes using the 0.1 N HCl solution assay. More preferably still, about 50% of the micronized eplerenone is dissolved in about 15 minutes, about 80% is dissolved at about 30 minutes and about 90% or more is dissolved in about 45 minutes.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials in an oral unit dosage form suitable for once-a-day or twice-a-day oral administration and capable of releasing in vitro at least 50% of the eplerenone contained in the composition within about 15 minutes in the SDS-containing medium. More preferably, about 50% of the micronized eplerenone is dissolved in about 20 minutes using the 0.1 N HCl solution assay. More preferably still, about 50% of the micronized eplerenone is dissolved in about 15 minutes, about 80% is dissolved at about 30 minutes and about 90% or more is dissolved in about 45 minutes.
- these pharmaceutical compositions comprise eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hydroxypropyl methylcellulose, sodium lauryl sulfate, talc, and magnesium stearate. It is particularly preferred that the various components of the compositions be present in the amounts or the weight fractions set forth above.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.1 to 7 weight percent of sodium lauryl sulfate; 0.1 to 10 weight percent of talc; 0.1 to 10 weight percent of magnesium stearate; and 0.1 to 10 weight percent colloidal silicon dioxide.
- the compositions are preferably in the form of unit dosage capsules.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.25 to 4 weight percent of sodium lauryl sulfate; 0.5 to 5 weight percent of talc; and 0.25 to 5 weight percent of magnesium stearate; and 0.1 to 5 weight percent colloidal silicon dioxide.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.25 to 1.5 weight percent of sodium lauryl sulfate; 1 to 4 weight percent of talc; and 0.1 to 1 weight percent of magnesium stearate; and 0.1 to 1.5 weight percent colloidal silicon dioxide.
- compositions of this embodiment are in the form of a capsule comprising:
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.25 mg to 18 mg of croscarmellose sodium; 0.1 mg to 5 mg of sodium lauryl sulfate; 0.5 mg to 8 mg of talc; about 0.1 mg to 5 mg of magnesium stearate; and 0.1 mg to 5 mg colloidal silicon dioxide.
- composition of this embodiment comprise:
- compositions optionally can additionally comprise 0.1 mg to 1.5 mg of sodium lauryl sulfate; 0.25 mg to 4.5 mg of talc; about 0.1 mg to 1.5 mg of magnesium stearate; and 0.1 to 2.5 weight percent colloidal silicon dioxide.
- the compositions are preferably in the form of unit dosage capsules.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 1 to 2.5 mg of sodium lauryl sulfate; 2 to 8 mg of talc; 0.25 mg to 1.5 mg of magnesium stearate; and 0.1 to 3 weight percent colloidal silicon dioxide.
- the compositions are preferably in the form of unit dosage capsules.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 4 mg of sodium lauryl sulfate; 8 to about 12 mg of talc; 0.5 mg to 3 mg of magnesium stearate; and 0.5 mg to 4 mg colloidal silicon dioxide.
- the compositions are preferably in the form of unit dosage capsules.
- Oral delivery of the pharmaceutical compositions of the present invention can include controlled release formulations, including controlled release formulations well known in'the art, providing prolonged or sustained delivery of the drug to the gastrointestinal tract by any number of mechanisms.
- Such prolonged or sustained release mechanisms can include, but are not limited to, pH sensitive release from the dosage form based on the changing pH of the small intestine; slow erosion of a tablet or capsule; retention in the stomach based on the physical properties of the formulation; bioadhesion of the dosage form to the mucosal lining of the intestinal tract; or enzymatic release of eplerenone from the dosage form.
- the intended effect is to extend the time period over which eplerenone is delivered to the site of action by manipulation of the dosage form.
- enteric-coated and enteric-coated controlled release formulations are within the scope of the present invention.
- the controlled release compositions comprise micronized eplerenone in a desired amount, preferably in a range as previously discussed above, that is, in an amount of 10 mg to 1000 mg, more preferably 20 mg to 400 mg, still more preferably 25 mg to 200 mg, and still more preferably 25 mg to 150 mg.
- Preferred controlled release compositions are in the form of tablets or capsules, particularly tablets or capsules comprising micronized eplerenone in an amount of 25 mg, 50 mg, 100 mg or 150 mg.
- the controlled release compositions may or may not be in a single dosage form. Such controlled release compositions, however, preferably are in a unit dose oral form.
- a once-a-day controlled release tablet or capsule typically comprises eplerenone in a range of 25 mg to 150 mg.
- a controlled-release dosage form as defined in US Pharmacopeia XXII includes 'extended release dosage forms that permit at least a two-fold reduction in dosing frequency as compared to the drug presented as a conventional dosage form and delayed release dosage forms which release the drug at a time other than promptly after administration.
- the controlled release composition can be, and preferably is, a sustained release or delayed/modified release form.
- Suitable matrix forming materials are waxes (e.g., carnauba, bees wax, paraffin wax, ceresine, shellac wax, fatty acids, and fatty alcohols); oils, hardened oils or fats (e.g., hardened rapeseed oil, castor oil, beef tallow, palm oil, and soya bean oil); polymers (e.g., hydroxypropyl cellulose, polyvinylpyrrolidone, hydroxypropyl methyl cellulose, polyethylene glycol, methacrylates (PMMA), and carbomer); alginates; xanthum gums; and other carrier materials known to those of ordinary skill in the art.
- waxes e.g., carnauba, bees wax, paraffin wax, ceresine, shellac wax, fatty acids, and fatty alcohols
- oils hardened oils or fats (e.g., hardened rapeseed oil, castor oil, beef tallow, palm oil, and soya bean
- suitable matrix tableting materials include, but are not limited to, microcrystalline cellulose, powdered cellulose, hydroxypropyl cellulose, and ethyl cellulose.
- Other types of controlled release compositions may achieve controlled release by use of granulates, coated powders, pellets, or the like, by use of multi-layering, and/or by used of suitable coatings.
- Still other controlled release compositions include an osmotic pump (such as described in GB 2207052 published January 25, 1989), or combinations of the above.
- Suitable coating materials for use in the preparation of controlled release compositions include, but are not limited to, any pharmaceutically acceptable polymer such as ethyl cellulose, cellulose acetate butyrate, cellulose acetates, polymethacrylates containing quaternary ammonium groups or other pharmaceutically acceptable polymers, polyethylene glycol, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyvinylpyrrolidone, and polyvinyl alcohol; monomeric materials such as sugars including lactose, sucrose, fructose and mannitol; salts including sodium chloride, potassium chloride and derivatives; organic acids including furmaric acid, succinic acid, lactic acid and tartaric acid and mixtures thereof; enteric polymers including polyvinyl acetate phthalate, cellulose acetate phthalate, cellulose acetate trimellitate, shellac, zein, and polymethacrylates containing carboxyl groups. These polymers can be applied as solutions or latexes. Other barriers
- the coating composition can be plasticized according to the properties of the coating blend such as the glass transition temperature of the main component or mixture of components or the solvent used for applying the coating compositions.
- Suitable plasticizers can be added from about 0% to about 50% by weight of the coating composition.
- plasticizers include, for example, the group consisting of diethyl phthalate, citrate esters, polyethylene glycol, glycerol, acetylated glycerides, and castor oil.
- Tablets or capsules containing micronized eplerenone can be coated directly to produce a controlled release dose, or can comprise a plurality of coated cores containing eplerenone.
- core refers to an element of the composition containing eplerenone and various carrier.
- Each core can contain an amount of micronized eplerenone in the range of 0.1% to 95%, preferably 10% to 80%, by weight based on the total weight of the core.
- the core typically can be 200 ⁇ m to 1700 ⁇ m in diameter.
- a pellet is a coated core with the coating being any suitable coating.
- controlled release compositions can be made by prilling, spray drying, pan coating, melt granulation, granulation, wurster coating, tangential coating, top spraying, tableting, extruding, coacervation and the like.
- the particle size of the controlled release components other than micronized eplerenone in the dosage form depends on the technology used. The particle sizes can range from submicron to 500 ⁇ m for powder technologies (mixtures, spray drying, dispersions, and the like); 5 ⁇ m to 1700 ⁇ m for coating technologies (wurster, top spray, bottom spray, spray drying, extrusion, layering, and the like) ; and 1 mm to 20 mm for tableting technologies.
- micronized eplerenone are then combined into a single dosage such that the amount of eplerenone in the composition of the invention provides the desired dosage.
- Standard coating procedures such as those described, for example, in Remington's Pharmaceutical Sciences , 18 th Edition (1990), can conveniently be used.
- compositions can include micronized eplerenone in an immediate release form in association with micronized eplerenone in a controlled release form.
- the immediate release form of such compositions can include an amount of micronized epierenone that is 0.5% to 90% of the total amount of eplerenone of the composition, with the controlled release form containing the remainder of the micronized eplerenone.
- the final composition provides an amount of micronized eplerenone for immediate release following administration and an additional amount of micronized. eplerenone for controlled release.
- composition of the invention is in the form of a pellet product
- the pellets can be presented in a sachet, capsule or tablet.
- the non-limiting example below describes pellets (particle sizes 200 pm to 1700 ⁇ m) in a capsule. All the quoted ranges are % w/w.
- a plurality of elements containing micronized eplerenone, or cores are prepared by extrusion/spheronization, or by layering eplerenone (or a blend of eplerenone with other carrier materials) onto inert carriers by various processes.
- the cores themselves can be immediate release or controlled release depending on the materials and method of manufacture.
- the cores can contain the micronized drug at the required potency according to the particular eplerenone dose, required size, required presentation, and subsequent processes (coating and the like).
- the cores can contain micronized eplerenone in the range of 0.1% to 100%, depending on the required dose, potency, manufacturing method,. and other properties.
- An extruded core typically includes micronized eplerenone and, for example, a diluent/disintegrant such microcrystalline cellulose (in the range 0.5% to 99.9%), a binding agent such as hydroxypropyl cellulose (in the range 0.5% to . 50%); a filler such as lactose (in the range of 0.5% to 90%); and other carrier materials.
- a diluent/disintegrant such microcrystalline cellulose (in the range 0.5% to 99.9%)
- a binding agent such as hydroxypropyl cellulose (in the range 0.5% to . 50%)
- a filler such as lactose (in the range of 0.5% to 90%)
- other carrier materials such as lactose (in the range of 0.5% to 90%).
- An extruded core can, where desired, only contain drug and binding agent.
- An extruded core with controlled release properties typically contains micronized eplerenone and a swelling/gelling polymer such as hydroxypropyl cellulose (in the range 0.5% to 50%), or a hydrophobic material such as cetyl alcohol (in the range of 10% to 90%).
- a layered core can contain micronized eplerenone and an inert carrier such as a sugar sphere (in the range 10% to 90%) with a binding agent (in the range 0.1% to 50%).
- the core can contain diluents, wetting agents and other additives.
- the binding agent can be chosen to achieve immediate release (such as hydroxypropyl cellulose, hydroxypropyl methylcellulose and the like), controlled release (such as ethyl cellulose, cellulose acetate butyrate and the like), or delayed/modified release (for example, enteric binding materials such as hydroxypropyl methylcellulose phthalate, polyvinylacetate phthalate and the like).
- immediate release such as hydroxypropyl cellulose, hydroxypropyl methylcellulose and the like
- controlled release such as ethyl cellulose, cellulose acetate butyrate and the like
- delayed/modified release for example, enteric binding materials such as hydroxypropyl methylcellulose phthalate, polyvinylacetate phthalate and the like.
- a portion of the final dosage form can be immediate release cores made by the above described processes.
- the immediate release cores can be coated with a rapidly disintegrating or dissolving coat for aesthetic, handling, or stability purposes.
- Suitable materials include polyvinylpyrrolidone, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyethylene glycol, and polymethacrylates containing free amino groups.
- Such materials can include plasticizers, antitack agents and/or diluents.
- An addition of about 3% of the weight of the core as coating material is generally regarded as providing a continuous coat for this size range.
- the controlled release portion of the dose can be provided by a controlled release core as described above, a controlled release core that is further modified by overcoating, or an immediate release core that is modified by overcoating.
- a typical coating composition for making the controlled release component can contain an insoluble matrix polymer in an amount of 15% to 85% by weight of the coating composition, and a water soluble material in an amount of 15% to
- Suitable insoluble matrix polymers include ethyl cellulose, cellulose acetate butyrate, cellulose acetates, and polymethacrylates containing quaternary ammonium groups or other pharmaceutically acceptable polymers.
- Suitable water soluble materials include polymers such as polyethylene glycol, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyvinylpyrrolidone, polyvinyl alcohol; monomeric materials such as sugars (e.g., lactose, sucrose, fructose, mannitol and the like); salts (e.g., sodium chloride, potassium chloride and the like); organic acids (e.g., fumaric acid, succinic acid, lactic acid, tartaric acid and the like) ; and mixtures thereof.
- polymers such as polyethylene glycol, hydroxypropyl cellulose, hydroxypropyl methylcellulose, polyvinylpyrrolidone, polyvinyl alcohol
- monomeric materials such as sugars (e.g., lactose, sucrose, fructose, mannitol and the like); salts (e.g., sodium chloride, potassium chloride and the like); organic acids (e.g., fumaric acid, succin
- Suitable enteric polymers include hydroxypropyl methylcellulose acetate succinate (HPMCAS), hydroxypropyl methylcellulose phthalate (HPMCP), polyvinyl acetate phthalate, cellulose acetate phthalate, cellulose acetate trimellitate, shellac, zein, polymethacrylates containing carboxyl groups, and the like.
- HPMCAS hydroxypropyl methylcellulose acetate succinate
- HPMCP hydroxypropyl methylcellulose phthalate
- polyvinyl acetate phthalate polyvinyl acetate phthalate
- cellulose acetate phthalate cellulose acetate trimellitate
- shellac zein
- polymethacrylates containing carboxyl groups and the like.
- the coating composition can be plasticized according to the properties of the coating blend such as the glass transition temperature of the main component or mixture of components or the solvent used for applying the coating compositions.
- Suitable plasticizers can be added from 0.1% to 50% by weight of the coating composition.
- Such plasticizers can be selected from, for example, the group consisting of diethyl phthalate, citrate esters, polyethylene glycol, glycerol, acetylated glycerides, acetylated citrate esters, dibutyl sebacate, castor oil and the like.
- the coating composition can include a filler.
- the filler can comprise 0.1% to 100% by weight based on the total weight of the coating composition.
- the filler can be an insoluble material such as silicon dioxide, titanium dioxide, talc, kaolin, alumina, starch, powdered cellulose, microcrystalline cellulose, polacrilin potassium, and the like.
- the coating composition can be applied as a solution or latex in organic solvents or aqueous solvents of mixtures thereof.
- the solvent is present in an amount of 25% to 99%, preferably 85% to 97%, by weight based on the total weight of dissolved solids.
- Suitable solvents are water, lower alcohol, lower chlorinated hydrocarbons, ketones or mixtures thereof.
- latexes are applied, the solvent is present in an amount of ; 25% to 97%, preferably 60% to 97%, by weight based on the quantity of polymeric material in the latex.
- the solvent can be predominantly water.
- a suitable tablet formulation can include micronized epierenone together with a swelling/gelling polymer such as L-hydroxypropyl cellulose admixed with a filler such as microcrystalline cellulose.
- the tablet carrier materials can be processed (i.e., spray dried) together, prior to compression. Matrix tablets of this type often exhibit a rapid initial release until the polymers swell and gel, which induces controlled release for the remainder of the drug.
- the quantity of immediate release and duration of controlled release can be varied by altering the quantities of the carrier materials used. If the immediate release component is not large enough, a quantity of micronized eplerenone can be included in a rapidly dissolving outer coat of polymers such as polyethylene glycol or hydroxypropyl methylcellulose.
- a typical matrix tablet can contain the swelling/gelling polymer in an amount of 5% to 70% by weight based on the total weight of the tablet, and a diluent in an amount of 15% to 90% by weight based on the total weight of the tablet. Additional diluents can be included in amounts from approximately 0.1% to 65% by weight based on the total weight of the tablet.
- These can be soluble materials such as lactose, mannitol, sorbitol and the like, or insoluble materials such as tribasic calcium phosphate powdered cellulose or any of the various starches (corn, wheat, potato and the like).
- the tablets can contain a lubricant in an amount of 0.1% to 8% by weight based on the total weight of the tablet.
- Lubricants can be selected from metal stearates, stearic acid, hydrogenated oils, such as soya bean oil or castor oil, sodium stearyl furnate, polytetrafluoroethylene, talc and the like.
- the tablets can be coated for aesthetic, handling or stability purposes, or to increase the quantity of the immediate release portion of eplerenone.
- micronized eplerenone is dissolved or suspended in the coating solution and sprayed onto the tablets until the desired quantity of eplerenone has been added.
- Suitable coating materials include polyethylene glycol, hydroxypropyl methylcellulose, hydroxypropyl cellulose, polyvinyl alcohol, polyvinylpyrrolidone, sugar, waxes, or mixtures of these.
- the coating material can be added to any desired thickness but weight gains in the range 1% to 20% are typical, preferably 2% to 10%, and more preferably 2% to 5%.
- the coat can be plasticized.
- a plasticizer can be present in an amount of 0.1% to 50% by weight based on the total weight of the tablet of the coating material. Examples of plasticizers are diethyl phthalate, citrate esters, acetylated citrate esters, polyethylene glycol, glycerol, dibutyl sebacate, acetylated monoglycerides, castor oil and the like).
- the coating composition can include an antitack agent such as talc, kaolin, titanium dioxide, silicon dioxide, alumina, starch, polacrilin potassium, microcrystalline cellulose or the like).
- an antitack agent such as talc, kaolin, titanium dioxide, silicon dioxide, alumina, starch, polacrilin potassium, microcrystalline cellulose or the like.
- the coating materials can be applied to the eplerenone particles, processed eplerenone particles (i.e. cores, granules), finished tablets, or finished capsules.
- the coating composition can also include a filler.
- the filler can comprise 0.1% to 100% by weight based on the total weight of the coating composition and can be an insoluble material such as silicon dioxide, titanium dioxide, talc, kaolin, alumina, starch, powdered cellulose, microcrystalline cellulose, polacrillin potassium.
- the coating composition can contain other ingredients such as dyes and waxes.
- the coat can be applied as a solution or suspension from aqueous or organic solvents using solution concentrations and equipment familiar to these skilled in the art.
- the coating composition can be applied as a solution or latex in organic solvents or aqueous solvents or mixtures thereof.
- the solvent is present in an amount of 25% to 99%, preferably 85% to 97%, by weight based on the total weight of dissolved solids.
- Suitable solvents are water, lower alcohols such as ethanol and iso-propanol, lower chlorinated hydrocarbons such as chloroform and dichloromethane, ketones such as acetone and methyl ethyl ketone, or mixtures thereof.
- latexes are applied, the solvent is present in an amount of 25% to 97%, preferably 60% to 97%, by weight based on the quantity of polymeric material in the latex.
- the solvent can be predominantly water.
- the controlled release component of a tablet can be provided in the form of controlled release pellets and the immediate release component can be included in the body of the tablet.
- a tablet disintegrates to release the immediate release drug and the controlled release pellets.
- Pellets can be present in an amount of 1% to 60%, preferably 5% to 50%, and more preferably 5% to 40%, by weight of the tablet.
- Suitable matrix materials for tablets of this type are microcrystalline cellulose, starches and the like.
- the immediate release form of the micronized eplerenone can be presented in a fast dissolving dosage form.
- the immediate release form can be in the form of a solid or molecular dispersion of the active within a polymer matrix.
- the polymer matrix can be selected from biologically acceptable polymers such as a cellulose ether, for example ethyl cellulose, or cellulose ester, for example cellulose acetate butyrate and the like.
- the immediate release form can simply be particles of eplerenone deposited on a core containing eplerenone.
- composition of the invention can include the two forms of the micronized eplerenone as separate components, for example, in a multi-layer tablet, wherein one or more layers include the micronized eplerenone in a controlled release form.
- the composition of the invention can' be in the form of a tablet wherein the immediate release form is present in the shell and the controlled release form constitutes the core.
- the two forms of the micronized eplerenone can be dispersed throughout the tablet.
- the composition of the invention can be produced by providing a core containing the micronized eplerenone controlled release component coated with an enteric or delayed release coating.
- the core can be in the form of beads compressed to a tablet.
- the coated core can then be compressed into tablets along with a powder mixture containing additional eplerenone, or filled in combination with uncoated eplerenone into a capsule shell.
- the final composition provides an amount of eplerenone for immediate release following administration and an additional amount of eplerenone for controlled release.
- the controlled release form of the micronized eplerenone is such as to provide sustained release of eplerenone.
- the controlled or sustained release form provides a therapeutic effect over a period greater than about 12 hours, with a sustained therapeutic effect period of 12 to 24 hours being especially preferred.
- the controlled release form can be in the form of coated beads or granules of micronized eplerenone.
- the coated micronized eplerenone can be combined with uncoated or lightly coated micronized eplerenone to provide a controlled release composition of the present invention.
- lightly coated as used in the description means a rapidly disintegrating coating for aesthetic, handling or stability purposes. These then can be filled into capsules or formed into tablets. Microencapsulation can also be used to produce the controlled release form of the micronized eplerenone.
- the coating or matrix material can be any suitable material.
- the coating or matrix material can be a polymer or a wax.
- the wax can be selected from any suitable wax or wax-like material including natural oil and fat and hardened oils such as hardened rapeseed oil, hardened castor oil, hardened beef tallow, palm oils and the like; waxes such as carnauba wax, bees wax, paraffin wax, ceresine wax, shellac wax or a fatty acid.
- Additional controlled release formulations can be prepared by appropriate modification of the formulations and methods disclosed in, for example, Jao et al., U.S. Patent 5,190,765; Jao et al., U.S. Patent 5,160,744; Wong et al., U.S. Patent 5,082,668; Ayer et al., U.S. Patent 4,847,093; EP 572942 A2 published December 8, 1993; EP 284039 A2 published September 28, 1988; EP 238189 A1 published September 23, 1987; WO94/27582 published December 8, 1994; WO92/13547 published August 20, 1992; and WO92/00729 published January 23, 1992,
- the pharmaceutical composition is a controlled release oral dosage form, preferably a tablet or capsule, wherein the release of eplerenone is controlled by the utilization of a hydrophilic matrix that releases micronized eplerenone at a relatively constant rate over a period of several hours.
- This hydrophilic matrix can be prepared, for example, by incorporating hydroxypropyl methylcellulose into the formulation in combination with the other carrier materials. The amount of hydroxypropyl methylcellulose required depends upon the release rate desired. Illustrative compositions having various in vitro dissolution rates are described in the examples below.
- the hydroxypropyl methylcellulose is combined with micronized eplerenone and other carrier materials, and then high shear wet granulated, fluid bed dried, blended and compressed into a tablet dosage form.
- the hydroxypropyl methylcellulose used preferably is a high molecular weight (or high viscosity) hydroxypropyl methylcellulose.
- high molecular weight (or high viscosity) hydroxypropyl methylcellulose refers to those hydroxypropyl methylcelluloses having a 2% viscosity (that is, the viscosity of a 2% solution of hydroxypropyl methylcellulose in water at 20°C) in the range of 3,500 cps to 5,600 cps.
- the tablet surface wets and the polymer begins to partially hydrate forming an outer gel layer.
- This outer gel layer becomes fully hydrated and begins to erode into the aqueous fluids. Water continues to permeate toward the core of the tablet permitting another gel layer to form beneath the dissolving outer gel layer.
- Typical two hour controlled release formulations ' (that is, formulations releasing about 50% of the eplerenone in vitro during the two hour period after ingestion) comprise 2% to 20%, preferably 3% to 17%, and more preferably 4% to 14%, high molecular weight hydroxypropyl methylcellulose by weight of the composition.
- Typical four hour controlled release formulations (that is, formulations releasing about 50% of the eplerenone in vitro during the four hour period after ingestion) comprise 5% to 45%, preferably 7% to 35%, and more preferably 8% to 28%, high molecular weight hydroxypropyl methylcellulose by weight of the composition.
- Typical six hour controlled release formulations (that is, formulations releasing about 50% of the eplerenone in vitro during the six hour period after ingestion) comprise 10% to 45%, preferably 12% to 35%, and more preferably 14% to . 35%, high molecular weight hydroxypropyl methylcellulose by weight of the composition.
- compositions comprise:
- compositions optionally can additionally comprise 0.1 to 2 weight percent of talc; and/or 0.25 to 0.75 weight percent of magnesium stearate.
- the pharmaceutical compositions of- this embodiment comprise 25 to 35 weight percent of micronized eplerenone; 35 to 45 weight percent of lactose; 14.5 to 24.5 weight percent of microcrystalline cellulose; 1 to 11 weight percent of high molecular weight hydroxypropyl methylcellulose; and 0.5 to 8 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 6 weight percent of talc; and 0.1 to 5.5 weight percent of magnesium stearate.
- the pharmaceutical compositions are controlled release compositions comprising:
- compositions optionally can additionally comprise 0.1 to 10 weight percent of talc; and 0.1 to 10 weight percent of magnesium stearate.
- the low molecular weight hydroxypropyl methylcellulose has a viscosity of from 2 cps to 8 cps, more preferably 2 cps to 6 cps, as discussed before.
- the high molecular weight hydroxypropyl methylcellulose has a 2% viscosity value of from 3500 cps to 5,600 cps, as also discussed before.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 25 to 35 weight percent of micronized eplerenone; 35 to 45 weight percent of lactose; 14.5 to 24.5 weight percent of microcrystalline cellulose; 1 to 11 weight percent of high molecular weight hydroxypropyl methylcellulose; and 0.5 to 8 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 6 weight percent of talc; and 0.1 to 5.5 weight percent of magnesium stearate.
- the pharmaceutical compositions of this embodiment comprise 28 to ' 32 weight percent of micronized eplerenone; 38 to 42 weight percent of lactose; 17.5 to 21.5 weight percent of microcrystalline cellulose; 4 to 8 weight percent of high molecular weight hydroxypropyl methylcellulose; and 2 to 5 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 3 weight percent of talc; and 0.1 to 2.5 weight percent of magnesium stearate.
- compositions are controlled release compositions comprising:
- compositions optionally may additionally comprise 0.1 to 10 weight percent of talc; and 0.1 to 10 weight percent of magnesium stearate.
- the low molecular weight hydroxypropyl methylcellulose has a viscosity of from 2 cps to 8 cps, more preferably 2 cps to 6 cps, whereas, the high molecular weight hydroxypropyl methylcellulose has a 2% viscosity value of from 3500 cps to 5,600 cps, as discussed before.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 25 to 35 weight percent of micronized eplerenone; 22 to 42 weight percent of lactose; 8.5 to 23.5 weight percent of microcrystalline cellulose; 5 to 35 weight percent of high molecular weight hydroxypropyl methylcellulose; and 0.5 to 8 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 6 weight percent of talc; and 0.1 to 5.5 weight percent of magnesium stearate.
- the pharmaceutical compositions of this embodiment comprise 28 to 32 weight percent of micronized eplerenone; about 25 to 39 weight percent of lactose; 11.5 to 20.5 weight percent of microcrystalline cellulose; 10 to 35 weight percent of high molecular weight hydroxypropyl methylcellulose; and 2 to 5 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 3 weight percent of talc; and 0.1 to 2.5 weight percent of magnesium stearate.
- compositions are controlled release compositions comprising:
- compositions optionally may additionally comprise 0.1 to 10 weight percent of talc; and 0.1 to 10 weight percent of magnesium stearate.
- the low molecular weight hydroxypropyl methylcellulose has a viscosity of from 2 cps to 8 cps, more preferably 2 cps to 6 cps, whereas the high molecular weight hydroxypropyl methylcellulose has a 2% viscosity value of from 3500 cps to 5,600 cps, as before.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of'this embodiment comprise about 28 to 32 weight percent of micronized eplerenone; 28.5 to 32.5 weight percent of lactose; 13 to 17 weight percent of microcrystalline cellulose; 18 to 22 weight percent of high molecular weight hydroxypropyl methylcellulose; and 2 to 5 weight percent of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.1 to 3 weight percent of talc; and 0.1 to 2.5 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 15 mg of talc; and 0.1 mg to 10 mg of magnesium stearate.
- the low molecular weight hydroxypropyl methylcellulose has a viscosity of from 2 cps to 8 cps, more preferably 2 cps to 6 cps, whereas the high molecular weight hydroxypropyl methylcellulose has a 2% viscosity value of from 3500 cps to 5,600 cps, as before.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 8 mg of talc; and 0.1 mg to 7 mg of magnesium stearate.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 98 mg to 102 mg of micronized eplerenone; 131 mg to 136 mg of lactose; 63 mg to 67 mg of microcrystalline cellulose; 18 mg to 22 mg of high molecular weight hydroxypropyl methylcellulose; and 8 mg to 12 mg of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 2 mg to 5 mg of talc; and 0.5 to 3 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 7 mg of talc; and 0.1 mg to 6 mg of magnesium stearate.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 48 mg to 52 mg of micronized eplerenone; 43 mg to 47 mg of lactose; 20.5 mg to 24.5 mg of microcrystalline cellulose; 40 mg to 44 mg of high molecular weight hydroxypropyl methylcellulose; and 3 mg to 7 mg of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 0.5 mg to 3 mg of talc; and 0.1 to 3 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 8 mg of talc; and 0.1 mg to 7 mg of magnesium stearate.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 98 mg to 102 mg of micronized eplerenone; 118 mg to 122 mg of lactose; 58 mg to 62 mg of microcrystalline cellulose; 38 mg to 42 mg of high molecular weight hydroxypropyl methylcellulose; and 8 mg to 12 mg of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 2 mg to 5 mg of talc; and 0.5 to 3 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 10 mg of talc; and 0.1 mg to 8 mg of magnesium stearate.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 148 mg to 152 mg of micronized eplerenone; 183 mg to 187 mg of lactose; 90.5 mg to 94.5 mg of microcrystalline cellulose; 48 mg to 52 mg of high molecular weight hydroxypropyl methyl cellulose; and 13 mg to 17 mg of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally may additionally comprise 3 mg to 7 mg of talc; and 0.5 to 4.5 weight percent of magnesium stearate.
- compositions of this embodiment comprise:
- compositions optionally can additionally comprise 0.5 mg to 8 mg of talc; and 0.1 mg to 7 mg of magnesium stearate.
- the compositions preferably are in the form of unit dosage tablets.
- the pharmaceutical compositions of this embodiment comprise 98 mg to 102 mg of micronized eplerenone; 99.5 mg to 103.5 mg of lactose; 48 mg to 52 mg of microcrystalline cellulose; 64.5 mg to 68.5 mg of high molecular weight hydroxypropyl methylcellulose; and 8 mg to 12 mg of low molecular weight hydroxypropyl methylcellulose.
- These pharmaceutical compositions optionally can additionally comprise 2 mg to 5 mg of talc; and 0.5 to 3 weight percent of magnesium stearate.
- compositions of this embodiment comprise lactose, microcrystalline cellulose, hydroxypropyl methylcellulose, talc, and magnesium stearate.
- the pharmaceutical compositions release in vitro at least about 50% of the eplerenone contained in the composition in at least about 1.5 hours, preferably in at least about 1.75 hours, and more preferably in about 2 hours.
- the pharmaceutical compositions release in vitro at least about 50% of the eplerenone contained in the composition in at least about 3.5 hours, preferably in at least about 3.75 hours, and more preferably in about 4 hours.
- the pharmaceutical compositions release in vitro at least about 50% of the eplerenone contained in the composition in at least about 5.5 hours, preferably in at least about 5.75 hours, and more preferably in about 6 hours.
- the pharmaceutical compositions comprise micronized eplerenone and one or more carrier materials, are in oral unit dosage form suitable for once-a-day or twice-a-day oral administration, and release in vitro about 50% or more of the eplerenone contained in the composition at least about 1.5 hours after ingestion of the composition.
- these pharmaceutical compositions comprise eplerenone and one or more carrier materials selected from the group consisting of lactose monohydrate, microcrystalline cellulose, hydroxypropyl methylcellulose, talc, and magnesium stearate. It is particularly preferred that the various components of the controlled release matrix be present in the amounts or the weight fractions set forth above.
- the pharmaceutical compositions of the present invention are also useful for the administration of other 9,11-epoxy-20-spiroxane compounds, particularly those 9,11-epoxy-20-spiroxane compounds that are aldosterone antagonists.
- These pharmaceutical compositions can be prepared as set forth in this application by replacing eplerenone with a comparable weight fraction of the desired 9,11-epoxy-20-spiroxane.
- the 9,11-epoxy-20-spiroxane compounds used in the preparation of such pharmaceutical compositions can be prepared, for example, as set forth in Grob et al., U.S. 4,559,332.
- Such 9,11-epoxy-spiroxanes include, but are not limited to, the following compounds:
- compositions can be used in therapeutic methods of treating a condition or disorder where treatment with an aldosterone receptor blocker is indicated, the methods comprising the oral administration of one or more of the pharmaceutical compositions previously described above to a patient in need thereof.
- the dosage regimen to prevent, give relief from, or ameliorate the condition or disorder preferably corresponds to once-a-day or twice-a-day oral dosages, and more preferably to the 25 mg, 50 mg, 100 mg or 150 mg eplerenone oral unit dosages discussed above, but can be modified in accordance with a variety of factors. These factors include the type, age, weight, sex, diet, and medical condition of the patient and the severity of the disease. Thus, the dosage regimen actually employed can vary widely and therefore deviate from the preferred dosage regimen set forth above.
- Initial treatment of a patient suffering from a condition or disorder where treatment with an aldosterone receptor blocker is indicated can begin with the dosages indicated above. Treatment is generally continued as necessary over a period of several weeks to several months or years until the condition or disorder has been controlled or eliminated. Patients undergoing treatment with the compositions disclosed herein can be routinely monitored by any of the methods well known in the art to determine the effectiveness of therapy. Continuous analysis of such data permits modification of the treatment regimen during therapy so that optimal effective amounts of compounds of the present invention are administered at any point in time, and so that the duration of treatment can be determined as well. In this way, the treatment regimen/dosing schedule can be rationally modified over the course of therapy so that the lowest amount of eplerenone exhibiting satisfactory effectiveness is administered, and so that administration is continued only so long as is necessary to successfully treat the condition or disorder.
- the present invention further encompasses the use of micronized eplerenone and a cellulosic carrier material in the manufacture of a medicament for the treatment or prophylaxis of aldosterone-mediated conditions or disorders.
- the present invention also is directed to methods for the preparation of pharmaceutical compositions comprising micronized eplerenone. Where tablets or capsules are desired, methods such as wet granulation, dry granulation or direct compression or encapsulation methods can be employed.
- wet granulation is a preferred method of preparing tablets from the pharmaceutical compositions of the present invention.
- the micronized eplerenone (and, if desired, any of the carrier materials) is initially milled or micronized to the desired particle size using a conventional mill or grinder.
- milling or grinding techniques are well known in the art, as are methods for ascertaining the resulting particle size and distribution.
- reduction of the D 90 eplerenone particle size (that is, the size of at least'90% of the eplerenone particles) in the composition is less than 400 microns and more than 25 microns, preferably less than 200 microns, more preferably less than 150 microns, still more preferably less than 100 microns, and yet more preferably less than 90 microns.
- a particularly preferred D 90 particle size is 30 to 110 microns, and more particularly still 30 to 50 microns. In other preferred embodiments, a particularly preferred D 90 particle size is 50 to 150 microns, and more preferably 75 to 125 microns. Micronized eplerenone so sized can materially increase the bioavailability of the eplerenone.
- Micronized eplerenone used illustratively herein typically had a D 90 value of 30 to 110 microns. Exemplary particle distributions are provided hereinafter for some of the specific examples.
- Particle size distributions are determined using the following procedure.
- the milled or micronized eplerenone is then blended, for example in a high shear mixer granulator, planetary mixer, a twin-shell blender or sigma mixer, with one or more of the carrier materials.
- the drug is blended with the diluent(s), disintegrant(s), binding agent(s) and, optionally, wetting agent(s) in this step although it is possible to add all or a portion of one or more of the carrier materials in a later step.
- this step of the process preferably comprises the blending of eplerenone, lactose, microcrystalline cellulose, hydroxypropyl methylcellulose and, optionally, sodium lauryl sulfate. It has been discovered that blending times as short as three minutes can provide a dry powder mixture having a sufficiently uniform distribution of eplerenone.
- Water is then added to the dry powder mixture and the mixture is blended for an additional period of time.
- the water can be added to the mixture at once, gradually over a period of time, or in several portions over a period of time.
- the water preferably is added gradually over a period of time, preferably at least about three to about five minutes.
- the wet granulated mixture comprise 25% to 45% water by weight.
- a higher or lower water content can be acceptable for certain formulations, a lower water content generally reduces the effectiveness of the step in producing granules having the desired compressibility and flowability properties, whereas a higher water content generally causes an increase in granule size.
- the wet granulated mixture is then dried, for example, in an oven or a fluidized bed dryer, preferably a fluidized bed drier. If desired, the wet granulated mixture can be wet milled, extruded or spheronized prior to drying, although wet milling is preferred.
- conditions such as inlet air temperature and drying time are adjusted to achieve the desired moisture content for the dried mixture. Increasing moisture content from about 2% to about 4% was observed to decrease initial tablet hardness.
- the dry granules are then reduced in size in preparation for compression.
- Conventional particle size reduction equipment such as oscillators or fitz mills can be employed.
- a suitable blender such as a twin-shell blender and the lubricant, anti-adherent agent and any additional carrier materials are added.
- blending times depend in part upon the process equipment used, it has been discovered that blending times of at least about 5 to 25 minutes are generally preferred.
- talc and the remaining portion of microcrystalline cellulose are added to the granules and the mixture blended for an additional period of time, preferably a period of time sufficient to achieve a blend uniformity relative standard deviation value of about 6% or less.
- Magnesium stearate is then added to the mixture and the mixture is blended for an additional period of time.
- the diluents include microcrystalline cellulose
- the addition of a portion of the microcrystalline cellulose during this step has been found to materially increase tablet hardness.
- increasing the amount of magnesium stearate was observed to decrease tablet hardness and increase friability and disintegration time.
- This blended mixture is then compressed into tablets (or encapsulated if capsules are to be prepared) to the desired weight and hardness using appropriate size tooling.
- Conventional compression and encapsulation techniques known to those of ordinary skill in the art can be employed.
- a 25 mg dose immediate release tablet (tablet diameter of 7/32") was prepared having the following composition: Table 1 INGREDIENT WEIGHT % OF TABLET Amount (mg) Eplerenone 29.41 25.00 Lactose Monohydrate (#310, NF) 42.00 35.70 Microcrystalline Cellulose (NF, Avicel® PH101) 18.09 (7.50% intragranular plus 10.59% extragranular) 15.38 Croscarmellose Sodium (NF, Ac-Di-SolTM) 5.00 4.25 Hydroxypropyl Methylcellulose (#2910, USP, PharmacoatTM 603) 3.00 2.55 Sodium Lauryl Sulfate (NF) 1.00 0.85 Talc (USP) 1.00 0.85 Magnesium Stearate (NF) 0.50 0.42 Total 100 85 Opadry® White YS-1-18027A 3.00 2.55 (Alternatively: Opadry® Yellow YS-1-12524-A) (4.50) (3.825)
- the lactose monohydrate used in each of the examples of the application is commercially available from Formost Farms, Baraboo, Wisconsin.
- the Avicel® brand of microcrystalline cellulose and the Ac-Di-SolTM brand of croscarmellose sodium were used in each of the examples of the application. Both compounds are commercially available from FMC Corporation, Chicago, Illinois.
- the PharmacoatTM 603 brand of hydroxypropyl methylcellulose was used in each of the examples of the application. This compound is commercially available from Shin-Etsu Chemical Co. Ltd.
- the sodium lauryl sulfate used in each of the examples of the application is commercially available from Henkel Corporation, Cincinnati, Ohio.
- the talc used in each of the examples of the application is commercially available from Cyprus Foote Mineral Co., Kings Mountain, North Carolina, or Luzenac America, Inc., Englewood, Colorado.
- the magnesium stearate used in each of the examples of the application is commercially available from Mallinckrodt Inc., St. Louis, Missouri.
- the Opadry® White YS-1-18027A (and other coatings) used to prepare the coated tablets disclosed in the examples of this application is a ready to coat coating formulation commercially available from Colorcon, West Point, Pennsylvania.
- a 50 mg dose immediate release tablet (tablet diameter of 9/32") was prepared having the following composition: Table 2 INGREDIENT WEIGHT % OF TABLET Amount (mg) Eplerenone 29.41 50.00 Lactose Monohydrate (#310, NF) 42.00 71.40 Microcrystalline Cellulose (NF, Avicel® PH101) 18.09 (7.50% intragranular plus 10.59% extragranular) 30.75 Croscarmellose Sodium (NF, Ac-Di-SolTM) 5.00 8.50 Hydroxypropyl Methylcellulose (#2910, USP, PharmacoatTM 603) 3.00 5.10 Sodium Lauryl Sulfate (NF) 1.00 1.70 Talc (USP) 1.00 1.70 Magnesium Stearate (NF) 0.50 0.85 Total 100 170 Opadry® White YS-1-18027A 3.00 5.10 (Alternatively: Opadry® Pink YS-1-14762-A) (3.00) (5.10)
- a 100 mg dose immediate release tablet formulation (tablet diameter of 12/32") was prepared having the following composition: Table 3 INGREDIENT WEIGHT % OF TABLET Amount (mg) Eplerenone 29.41 100.00 Lactose Monohydrate (#310, NF) 42.00 142.80 Microcrystalline Cellulose (NF, Avicel® PH101) 18.09 (7.50% intragranular plus 10.59% extragranular) 61.50 Croscarmellose Sodium (NF, Ac-Di-SolTM) 5.00 17.00 Hydroxypropyl Methylcellulose (#2910, USP, 3.00 10.20 PharmacoatTM 603) Sodium Lauryl Sulfate (NF) 1.00 3.40 Talc (USP) 1.00 3.40 Magnesium Stearate (NF) 0.50 1.70 Total 100 340 Opadry® White YS-1-18027A 3.00 10.20 (Alternatively: Opadry® Red YS-1-15585-A) (3.00) (10.20)
- a 10 mg dose immediate release capsule formulation was prepared having the following composition: Table 4 INGREDIENT AMOUNT (mg) REPRESENTATIVE BATCH AMOUNT (kg) Eplerenone 10.0 1.00 Lactose, Hydrous NF 306.8 30.68 Microcrystalline Cellulose, NF 60.0 6.00 Talc, USP 10.0 1.00 Croscarmellose Sodium, NF 8.0 0.80 Sodium Lauryl Sulfate, NF 2.0 0.20 Colloidal Silicon Dioxide, NF 2.0 0.20 Magnesium Stearate, NF 1.2 0.12 Total Capsule Fill Weight 400.0 40.00 Hard Gelatin Capsule, Size #0, 1 Capsule 100,000 Capsules
- a 25 mg dose immediate release capsule formulation was prepared having the following composition: Table 5 INGREDIENT (mg) AMOUNT REPRESENTATIVE BATCH AMOUNT (kg) Eplerenone 25.0 2.50 Lactose, Hydrous NF 294.1 29.41 Microcrystalline Cellulose, NF 57.7 5.77 Talc, USP 10.0 1.00 Croscarmellose Sodium, NF 8.0 0.80 Sodium Lauryl 2.0 0.20 Sulfate, NF Colloidal Silicon Dioxide, NF 2.0 0.20 Magnesium Stearate, NF 1.2 0.12 Total Capsule Fill Weight 400.0 40.00 Hard Gelatin Capsule, Size #0, White Opaque 1 Capsule 100,000 Capsules
- a 50 mg dose immediate release capsule formulation was prepared having the following composition: Table 6 INGREDIENT AMOUNT (mg) REPRESENTATIVE BATCH AMOUNT (kg) Eplerenone 50.0 5.00 Lactose, Hydrous NF 273.2 27.32 Microcrystalline Cellulose, NF 53.6 5.36 Talc, USP 10.0 1.00 Croscarmellose Sodium, NF 8.0 0.80 Sodium Lauryl Sulfate, NF 2.0 0.20 Colloidal Silicon Dioxide, NF 2.0 0.20 Magnesium Stearate, NF 1.2 0.12 Total Capsule Fill Weight 400.0 40.00 Hard Gelatin Capsule, Size #0, White Opaque 1 Capsule 100,000 Capsules
- a 100 mg dose immediate release capsule formulation was prepared having the following composition: Table 7 INGREDIENT AMOUNT (mg) REPRESENTATIVE BATCH AMOUNT (kg) Eplerenone 100.0 10.00 Lactose, Hydrous NF 231.4 23.14 Microcrystalline Cellulose, NF 45.4 4.54 Talc, USP 10.0 1.00 Croscarmellose Sodium, NF 8.0 0.80 Sodium Lauryl Sulfate, NF 2.0 0.20 Colloidal Silicon Dioxide, NF 2.0 0.20 Magnesium Stearate, NF 1.2 0.12 Total Capsule Fill Weight 400.0 40.00 Hard Gelatin Capsule, Size #0, White Opaque 1 Capsule 100,000 Capsules
- a 200 mg dose immediate release capsule formulation was prepared having the following composition: Table 8 INGREDIENT AMOUNT (mg) REPRESENTATIVE BATCH AMOUNT (kg) Eplerenone 200.0 20.00 Lactose, Hydrous NF 147.8 14.78 Microcrystalline Cellulose, NF 29.0 2.90 Talc, USP 10.0 1.00 Croscarmellose Sodium, NF 8.0 0.80 Sodium Lauryl Sulfate, NF 2.0 0.20 Colloidal Silicon Dioxide, NF 2.0 0.20 Magnesium Stearate, NF 1.2 0.12 Total Capsule Fill Weight 400.0 40.00 Hard Gelatin Capsule, Size #0, White Opaque 1 Capsule 100,000 Capsules
- a series of oral solutions is prepared containing 2.5 mg/L of eplerenone and having the following composition: up to 20% ethanol v/v; up to 10% propylene glycol v/v; about 10% to 70% glycerol v/v; and about 30% to 70% water v/v.
- Another series of oral solutions is prepared containing 2.5 mg/L of eplerenone and further comprising ethanol, propylene glycol, polyethylene glycol 400, glycerin and 70% w/w sorbitol.
- Another oral solution is prepared in the following manner.
- a 15% hydroxypropyl- ⁇ -cyclodextrin solution (20 mL) is added to a bottle containing eplerenone (100 mg).
- the bottle containing the mixture is placed in a temperature controlled water bath/shaker at 65°C and shaken for 20 minutes.
- the bottle is removed from the water bath and permitted to cool at room temperature for about five minutes.
- Apple juice 60 mL, commercially available is added to the mixture in the bottle and the contents of the bottle are gently swirled.
- the oral solutions of this example are particularly useful in the treatment of, for example, non-ambulatory patients, pediatric patients and patients that have difficulty taking solid dosage forms such as tablets and capsules.
- Tablets containing a 100 mg dose of eplerenone and having the composition set forth in Table 10A were prepared by wet granulation (total batch size of 70 g). These 100 mg dose tablets had an average disintegration time of about 16 minutes and an average tablet hardness of about 16 kP to 17 kP.
- Table 10A INGREDIENT WEIGHT FRACTION (%) Eplerenone 30.0 Lactose, Hydrous 25.0 Avicel®, PH 101 37.5 Ac-Di-SolTM 2.0 PharmacoatTM 603 3.0 Sodium Lauryl Sulfate, NF 1.0 Talc 1.0 Magnesium Stearate 0.5 Total 100
- composition set forth in Table 10A was then modified by adjusting the Ac-Di-SolTM weight fraction of the composition to values from 2% to 5%, while maintaining the weight fraction ratio of lactose/Avicel® at 25/37.5.
- Tablets containing a 100 mg dose of eplerenone and having these modified compositions were prepared by wet granulation (total batch size of 70 g). The mean disintegration results for these 100 mg dose tablets are reported in Table 10B below.
- An increase of the Ac-Di-SolTM weight fraction to 5% resulted in a reduction in disintegration time to less than 10 minutes where no other change was made to the composition.
- Table 10B AC-DI-SOLTM WEIGHT FRACTION (%) DISINTEGRATION TIME (MINUTES) 2 14.11 ⁇ 0.74 3 13.90 ⁇ 0.34 4 13.84 ⁇ 0.62 5 6.88 ⁇ 0.48
- composition was then further modified as set forth in Table 10C to evaluate the effect on disintegration time of adding the disintegrant extragranularly (that is, the ingredient is added after the wet granulated mixture had been dried) as well as intragranularly (that is, the ingredient is present in the mixture during the wet granulation step).
- the weight fraction ratio of lactose/Avicel® for these compositions also was adjusted about 43/17.5 to about 45/17.5 to increase the compressibility of the compositions.
- Tablets containing a 100 mg dose of eplerenone and having these modified compositions were prepared by wet granulation (total batch size of 70 g). The mean disintegration results for these 100 mg dose tablets are reported in Table 10C below.
- the 5% Ac-Di-SolTM intragranular/7.5% intragranular Avicel®/10% extragranular Avicel® composition was prepared as set forth in Table 10F. Tablets containing a 100 mg dose of eplerenone and having this composition were prepared by wet granulation (total batch sizes of 2 kg and 10 kg). Table 10F INGREDIENT WEIGHT FRACTION (%) Eplerenone 30 Lactose, Hydrous 42 Avicel®, PH 101 7.5 intra/10 extra Ac-Di-SolTM 5 PharmacoatTM 603 3 Sodium Lauryl Sulfate, NF 1 Talc 1 Magnesium Stearate 0.5 Total 100 *See Table 10C.
- a controlled release tablet (tablet weight 333.3 mg; round, standard, concave, 12/32") containing a 100 mg dose of eplerenone was prepared.
- the tablet had the following composition: Table 11 INGREDIENT WEIGHT % OF TABLET Eplerenone 30.0 Lactose Monohydrate 40.0 Microcrystalline Cellulose (Avicel® PH 101) 19.5 Hydroxypropyl methylcellulose (Methocel® K4M Premium) 6.0 Hydroxypropyl methylcellulose 3.0 (PharmacoatTM 603) Talc 1.0 Magnesium Stearate 0.5 Total 100
- Controlled release tablets (round standard concave) containing 50 mg (9/32"), 100 mg (12/32") and 150 mg (14/32") doses of eplerenone were prepared.
- the tablets had the following compositions: Table 12 WEIGHT % OF TABLET INGREDIENT 50 mg 100 mg 150 mg Eplerenone 30.0 30.0 30.0 Lactose Monohydrate 27.0 35.7 37.0 Microcrystalline Cellulose (Avicel® PH 101) 13.5 17.8 18.5 Hydroxypropyl methylcellulose (Methocel® K4M Premium) 25.0 12.0 10.0 Hydroxypropyl methylcellulose (PharmacoatTM 603) 3.0 3.0 3.0 Talc 1.0 1.0 1.0 1.0 1.0 1.0 Magnesium 0.5 0.5 0.5 Stearate Total 100 100 100 100 100
- a controlled release tablet (tablet weight 333.3 mg; round, standard, concave, 12/32") containing a 100 mg dose of eplerenone was prepared.
- the tablet had the following composition: Table 13 INGREDIENT WEIGHT % OF TABLET Eplerenone 30.0 Lactose Monohydrate 30.5 Microcrystalline Cellulose (Avicel® PH 101) 15.0 Hydroxypropyl methylcellulose (Methocel® K4M Premium) 20.0 Hydroxypropyl methylcellulose (PharmacoatTM 603) 3.0 Talc 1.0 Magnesium Stearate 0.5 Total 100
- Tablets containing a 100 mg dose or a 200 mg dose of eplerenone and having one of the compositions set forth in Table 14A below were prepared by wet granulation (total batch size of 1 kg).
- tablets containing a 100 mg dose or a 200 mg dose of eplerenone and having formulation C set forth in Table 14A were prepared by wet granulation (total batch size of 2 kg).
- Tablets prepared from the 2 kg batch exhibited a loss of tablet hardness and compressibility relative to tablets prepared from the 1 kg batch (Formulation C).
- Average tablet hardness for the 100 mg dose tablets prepared from the 2 kg batch was about 7 kP.
- Average tablet hardness for the 200 mg dose tablets prepared from the 1 kg batch was about 9 kP.
- placebo granulations with a high microcrystalline cellulose weight fraction did not compress into tablets.
- the granulation time of about 10 to 12 minutes resulted in an increased loss of water due to evaporation during granulation relative to the 1 kg batch.
- Tablets were then prepared containing a 100 mg dose of eplerenone and having the composition of Formulation C above or the composition of Formulation C above wherein the lactose and Avicel® weight fractions were reversed.
- the tablets were prepared by wet granulation (total batch size of 70 g) using different granulation times. Tablet compression was carried out on an F3 single punch press. As shown in Table 14B below, the combination of longer granulation times and higher microcrystalline cellulose content resulted in a loss of hardness. sensitivity to granulation conditions decreased when the lactose/microcrystalline cellulose ratio was adjusted from 10/35.5 to 30.5/15.
- Controlled release (“CR”) tablets containing a 100 mg dose of eplerenone and having one of the compositions set forth in Table 14C below were prepared by wet granulation (total batch size of 70 g). The average in vitro dissolution times in 1% SDS in water for each composition were then measured. The 2 hour 100 mg dose CR tablet was 37% dissolved at two hours. The 4 hour 100 mg dose CR tablet was 42% dissolved at four hours. The 6 hour 100 mg dose CR tablet was 54% dissolved at six hours.
- Two hour CR, 4 hour CR, and 6 hour CR tablets containing a 100 mg dose of eplerenone were prepared by wet granulation in a scaled-up process (total batch sizes of 2 kg and 10 kg).
- the tablets had the same compositions as set forth in Table 14C above except that the 2 hour CR and 4 hour CR tablet compositions had high molecular weight hydroxypropyl methylcellulose (Methocel® K4M Premium) weight fractions of 6% and 12%, respectively, and microcrystalline cellulose weight fractions of 19.5% and 17.5%, respectively.
- Tables 14D, 14E and 14F report the experimental results. Dissolution profiles can be further adjusted by appropriate selection of high molecular weight hydroxypropyl methylcellulose concentrations.
- dissolution time decreases as hydroxypropyl methylcellulose particle size increases. This is likely due to poor hydration of the hydroxypropyl methylcellulose matrix as particle size increases. Smaller particle size, on the other hand, appears to cause rapid hydration of the matrix and therefore slower drug release rate.
- Table 14D 2 Hour CR Tablet (100 mg Dose) PARAMETER MEASURED 70 g BATCH 1 2 kg BATCH 10 kg BATCH % Water Added 38.57 30.71 29.71 Granulation Time (minutes) 4.00 4.07 4.00 Drying Time (minutes) 60 30 11 Moisture Content (%) 2.0 1.28 1.62 Granule Density (g/cc) 0.55 0.58 0.63 Tablet Hardness (kp) 14.05 13.79 11.37 Tablet Thickness (mm) 4.58 4.40 4.4 % Friability 0.351 0.263 0.39 1 Tablets prepared from the 70 g batch had the composition set forth in Table 14C.
- compositions containing varying amounts of hydroxypropyl methylcellulose were prepared, compressed into different tablet sizes, and evaluated for dissolution time.
- the hydroxypropyl methylcellulose weight fraction of each composition is set forth in Tables 14G and 14H below.
- the eplerenone, PharmacoatTM 603, talc and magnesium stearate weight fractions were fixed at 30%, 3%, 1% and 0.5%, respectively.
- the ratio of lactose/microcrystalline cellulose was fixed at 2:1 and the amount of lactose and microcrystalline cellulose adjusted accordingly to accommodate the change in hydroxypropyl methylcellulose (HPMC) concentration.
- Tables 14G and 14H below report mean dissolution results in 1% SDS for the compositions.
- Table 14G reports the approximate times at which the tablets had achieved an in vitro dissolution of 50%, whereas Table 14H reports the in vitro dissolution in 1% SDS achieved at 24 hours.
- dissolution rate increased as tablet size decreased and/or when tablet shape was changed from standard round shape to a caplet shape.
- Table 14I further summarizes the results of Table 14G above with respect to 4 hour CR compositions. Based on the experimental data, hydroxypropyl methylcellulose (HPMC) concentrations of 35%, 25%, 12%, and 10% can be used with eplerenone dosages of 25 mg, 50 mg, 100 mg and 150 mg to achieve 50% in vitro dissolution in 1% SDS times (DT 50 ) of about 4 hours.
- HPMC hydroxypropyl methylcellulose
- eplerenone dosages 25 mg, 50 mg, 100 mg and 150 mg to achieve 50% in vitro dissolution in 1% SDS times (DT 50 ) of about 4 hours.
- Table 14I EPLERENONE DOSE (mg) HPMC WEIGHT FRACTION (%) PUNCH SIZE (ROUND.
- Table 15 TABLET DISINTEGRATION TIME
- Example 1 25 mg Dose 8 minutes, Tablet (Coated) 6 seconds
- Example 1 25 mg Dose 6 minutes, Tablet (Uncoated) 16 seconds
- Example 2 50 mg Dose 9 minutes, Tablet (Coated) 17 seconds
- Example 2 50 mg Dose 7 minutes, Tablet (Uncoated ) 39 seconds
- Example 3 100 mg Dose 10 minutes, Tablet (Coated) 30 seconds
- the apparatus of U.S.P. II (with paddles) was used to determine the dissolution rate in 1% SDS of the tablets of Examples 1, 2 and 3 for both coated and uncoated immediate release tablets.
- a 1000 mL 1% sodium lauryl sulfate (SDS)/99% water solution was used as the dissolution fluid.
- the sample from each vessel was filtered and the absorbance of the sample measured (UV spectrophotometer; 2 mm path length quartz cell; 243 nm or wavelength of UV maxima; blank: dissolution medium). Percent dissolution was calculated based on the measured absorbances. The results of the dissolution tests are reported in Table 16A.
- Example 1 25 mg Dose Tablet (Coated) 92 99 100 101
- Example 1 25 mg Dose Tablet (Uncoated) 92 98 99 99
- Example 2 50 mg Dose Tablet (Coated) 90 100 102 103
- Example 2 50 mg Dose Tablet (Uncoated ) 89 97 98 98
- Example 3 100 mg Dose Tablet (Coated) 82 95 97 98
- Example 3 100 mg Dose Tablet (Uncoated) 84 94 96 96
- Example 16C A similar study was carried out using 100 mg coated tablets prepared as discussed in Example 3 in which the eplerenone had a D 90 particle size of 45 microns, as in Example 3, 165 microns and 227 microns. Six tablets were used for each study rather than twelve as above. The results of that study are shown in Table 16B, below. The particle size distribution of those three samples is shown in Table 16C, hereinafter.
- Example 16 The procedure of Example 16 using 1% SDS was followed to test the 100 mg dose controlled release tablets of Examples 11 and 13 and the 50 mg, 100 mg and 150 mg dose controlled release tablets of Example 12. The mean results of the dissolution tests are reported in Table 17. Table 17 Dissolution (%) Time (Hours) 2 Hour CR Tablet (Example 11: 100 mg Dose) 4 Hour CR Tablet (Example 12) 6 Hour CR Tablet (Example 13: 100 mg Dose) 50 mg Dose 100 mg Dose 150 mg Dose 0.5 5 6 7 7 4 1 8 12 13 13 7 2 18 25 27 26 15 3 29 38 40 39 24 4 48 51 53 51 33 6 86 74 74 71 49 8 100 87 91 87 64 9 -- 97 101 100 -- 24 104 -- -- -- -- 105
- Table 18 shows the results of a particle size sieve analysis of small scale wet granulated batches of the pharmaceutical compositions of Examples 1, 11, 12 and 13 prior to compression into the tablets. "Cumulative Percent of Batch" reports the percent of the total batch having a particle size larger than the indicated sieve size.
- Table 18 CUMULATIVE PERCENT OF BATCH SIEVE SIZE (MICRONS) IR* (Ex. 1 Comp.) 2 Hour CR (Ex. 11 Comp.) 4 Hour CR (Ex. 12 Comp. 100 mg Dose) 6 Hour CR (Ex.
- Table 19 shows the mean results of a bulk density analysis of several small scale wet granulated batches of the pharmaceutical compositions of Examples 1, 11, 12 and 13 prior to compression into the tablets: Table 19 COMPOSITION BULK DENSITY (g/mL 3 )
- Example 1 Immediate Release 0.568
- Example 11 2 Hour Controlled Release 0.622
- Example 11 4 Hour Controlled Release 0.565
- Example 1 4 Hour Controlled Release 0.473
- Table 20 shows the results of the tablet analysis program ("TAP analysis") for a sampling of tablets of having the composition of the tablets of Examples 1, 2, 3, 11, 12 and 13.
- AVERAGE WEIGHT mg
- AVERAGE THICKNESS mm
- HARDNESS kP
- Example 1 25 mg Dose (IR*, Film Coated) 88.5 3.3157 7.64
- Example 1 25 mg Dose (IR, Uncoated) 85.5 3.2845 4.55
- Example 2 50 mg Dose (IR, Uncoated) 170.5 4.0297 7.31
- Example 2 50 mg Dose (IR, Film Coated) 176.0 4.093 10.95
- Example 3 100 mg Dose (IR, Film Coated) 349.6 4.546 13.91
- Example 11 100 mg Dose (2 Hour CR* ) 329.7 4.412 11.53
- Example 12 50 mg Dose
- Example 1 100 mg Dose (IR*) 0.177
- Example 2 50 mg Dose (IR) 0.236
- Example 3 25 mg Dose (IR) 0.000
- Example 11 100 mg Dose (2 Hour CR*) 0.42
- Example 12 100 mg Dose (4 Hour CR) 0.33
- Example 13 100 mg Dose (6 Hour CR) 0.12 See Table 19 notes.
- ingredients of the pharmaceutical compositions of the present invention can be prepared in accordance with acceptable pharmaceutical manufacturing practices in the manner illustrated by the flow of Figs. 1A and 1B for small scale preparations.
- Table 22 INGREDIENT WEIGHT % OF TABLET AMOUNT OF STARTING MATERIAL (KG/BATCH) Eplerenone 29.41 4.412 Lactose Monohydrate (#310, NF) 42.00 6.3 Microcrystalline Cellulose (intragranular) (NF, Avicel® PH101) 7.50 1.125 Croscarmellose Sodium (NF, Ac-Di-SolTM) 5.00 0.75 Hydroxypropyl Methylcellulose (#2910, USP, PharmacoatTM 603) 3.00 0.45 Sodium Lauryl Sulfate (NF) Sterile water for irrigation 1.00 0.15 Talc (USP) 1.00 0.15 Microcrystalline Cellulose (extragranular) (NF, Avicel® PH101) 10.59 1.588 Magnesium Stearate (NF) 0.50 0.075 Total 100.00 15.00
- the eplerenone was milled in a jet mill.
- the resulting milled eplerenone had D 10 , D 50 and D 90 values of 2.65 microns, 23.3 microns and 99.93 microns, respectively.
- 10%, 50% and 90% of the eplerenone particles were less than 2.65 microns, 23.3 microns and 99.93 microns, respectively, in size.
- a pin mill is preferred for preparation on a manufacturing scale.
- a 65 L NiroTM Fielder granulator was loaded with the lactose, eplerenone, Avicel®, Ac-Di-SolTM, PharmacoatTM 603 and sodium lauryl sulfate in this order. These materials were mixed to homogeneity (about three minutes) with the main blade on the slow main blade setting and the chopper blade on the slow chopper blade setting.
- a machine such as a Bukler PerkinsTM 1000L granulator can be used.
- Wet Granulation The dry powder mixture was wet granulated using USP water. The main blade and chopper blade of the granulator were placed on the fast speed setting. Five kilograms of water were added to the mixture over a period of about three minutes using a MasterflexTM water pump, model 7524-00 (24" tubing). The rate of water addition was about 1.66 kg/minute. The wet mixture was blended for an additional minute to ensure the uniform distribution of the water in the granulation. The wet granulated mixture was about 38% water by weight.
- the wet granulation was placed in a FreundTM Flo-coater (FLF-15) fluid bed dryer.
- the inlet air temperature was adjusted to about 68°C and the granulation was dried in the fluid bed dryer to reduce the moisture content to between 0.5% to 2.5%.
- Moisture content was monitored using a ComputracTM Moisture Analyzer.
- Dry Screening The dry granules were passed through a fitz mill with a 20# screen, knives forward, and 2400 rpm speed.
- Blending and Lubrication The dry granules were then placed in a PK 2 cubic foot V-blender. The talc and extragranular Avicel® 101 were placed on top of the granules and the mixture blended to homogeneity (about 10 minutes). The magnesium stearate was placed on top of the mixture and the mixture blended for an additional three minutes. A CroffTM Flow blender can be used for large scale preparations.
- Table 23 An illustrative formulation process using the starting materials of Table 23 is set forth below. The process can be operated as a single batch reaction or as two or more parallel batch reactions.
- Table 23 INGREDIENT WEIGHT % OF TABLET (100 mg Tablet) AMOUNT/BATCH (kg) Eplerenone 30.0 3.0 Lactose Monohydrate 34.0 3.4 Microcrystalline Cellulose (Avicel® PH 101) 19.5 1.95 Hydroxypropyl methylcellulose (Methocel® K4M Premium) 12.0 1.2 Hydroxypropyl methylcellulose (PharmacoatTM 603) 3.0 0.3 Talc 1.0 0.1 Magnesium Stearate 0.5 0.05 Total 100 10
- wet granulation The dry powder mixture was wet granulated using USP water. The main blade and chopper blade of the blender were placed on the fast speed setting. About 3.1 kg of water was added to the mixture over a period of about three minutes using an AeromaticTM water pump. The rate of water addition was about 995 g/minute. The wet mixture was blended for an additional minute to ensure the uniform distribution of the water in the granulation. The wet granulated mixture was about 31% water by weight.
- the wet granulation was placed in an AeromaticTM fluid bed dryer.
- the inlet air temperature was set at about 60°C and the granulation was dried in the fluid bed dryer to reduce the moisture content to between 1% to 3%.
- Moisture content of the granules was monitored using a ComputracTM Moisture Analyzer.
- Dry Screening The dry granules were passed through a fitz mill (D6A) with 20# screen, knives forward and medium speed (1500-2500 rpm). The milled granules were collected in a polyethylene bag.
- Lubrication The dry granules were placed in a PK 2 cubic foot V-blender. The talc was placed on top of the granulation and blended for 5 minutes. The magnesium stearate was then placed on top of the granulation and blended for 3 minutes. The granulation was discharged from the blender into a fiber drum lined with double polyethylene bags.
- the granulation was compressed on a KorschTM tablet press to the desired weight and hardness using 12/32" round standard concave tooling.
- Target weight was 333.3 mg and target hardness was 11-13 kP for 100 mg tablets.
- a CompulabTM Coater with 36" coating pan and one spray gun was used.
- the atomization air was set at 45 psi.
- the tablets were weighed and the amount of the coating suspension required to be sprayed in order to give 3% weight gain for tablets was determined.
- the tablets were loaded in the pan and the air flow set to 700 cubic feet per minute.
- the tablets were allowed to warm up for approximately 10 minutes by jogging the pan every two minutes.
- the inlet air temperature was set at 65°C.
- the exhaust temperature obtained was about 45°C. Rotation of the pan at 10 rpm was initiated and spraying starting.
- the spray rate was set at 50 g/min.
- the process was monitoring by checking and recording the coating parameters at each time interval.
- the coating process continued until the required quantity of coating suspension was sprayed, at which time spraying was discontinued.
- Pan rotation continued for an additional two to five minutes.
- the air heater was turned off and the pan rotation stopped.
- the tablets were allowed to cool for 10 minutes and the pan was jogged every two minutes during cooling.
- the coated tablets were discharged from the coating pan into fiber drums lined with double polyethylene bags.
- the pharmacokinetic profiles were evaluated using the measured blood and urine levels of eplerenone, the open lactone ring form of eplerenone and spironolactone.
- Antialdosterone activity was determined based on urine levels of sodium and potassium following repeated administration of fludrocortisone. Safety was determined on the basis of laboratory tests, vital signs, and the occurrence and types of adverse events.
- the eplerenone capsules administered corresponded to the capsules (or combinations of the capsules) disclosed in Examples 4, 5, 7 and 8 above.
- the placebo was a conventional capsule containing lactose.
- the spironolactone used in the study was obtained from Searle Canada (Oakville, Ontario).
- the fludrocortisone used in the study consisted of commercially available fludrocortisone tablets (Florinef®, Squibb BV).
- a 12-lead ECG was obtained prior to dosing (within one hour) and at 2, 3, 4 and 24 hours after administration of the study medication.
- Body temperature (oral), respiratory rate, and pulse rate and blood pressure (after sitting for three minutes) were obtained prior to dosing (within one hour) and at 0.25, 0.5, 1, 2, 4, 8, 12, and 24 hours after administration of the study medication.
- Blood samples were collected at -0.25 (predose), 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 24, 28, 32, 48, 72 and 96 hours post dose.
- Urine samples were collected for the following periods: -9 to 0; 0 to 2; 2 to 4; 4 to 6; 6 to 8; 8 to 10; 10 to 12; 12 to 14; 14 to 16; and 16 to 24 hours.
- the plasma samples collected from subjects dosed with eplerenone were assayed for concentrations of eplerenone and the open lactone ring form of eplerenone.
- the plasma samples of the subjects dosed with spironolactone were assayed for concentration of spironolactone and its active metabolites canrenone, 7 ⁇ -thiomethylspirolactone, and 6 ⁇ -hydroxy-7 ⁇ -thiomethylspirolactone.
- a subset of plasma samples was also assayed for testosterone levels.
- the urine collected was analyzed to determine concentrations and amounts of eplerenone and the open lactone ring form of eplerenone, the amount of sodium and potassium excreted, and the urinary log 10 (sodium/potassium) ratio.
- Plasma concentration of eplerenone was about 15 to 20 times greater than plasma concentrations of the open ring lactone form.
- Table 24D Pharmaco-kinetic Parameter Pharmacokinetic Parameter Value (Open Ring Lactone) 10 mg (Epl.*) 50 mg (Epl.) 100 mg (Epl.) 300 mg (Epl.) 1000 mg (Epl.) AUC (0-96) [(ng/mL)hr] -- 142.8 246.8 1065.1 3483.5 C max ( ⁇ g/mL) -- 36.4 60.4 211.8 521.5 T max (hours) -- 1.0 1.1 1.3 2.5 T 1 ⁇ 2 (hours) -- 2.7 2.7 2.8 2.6 Mean Residence Time (hours) -- 2.8 3.3 4.2 5.7 Oral Clearance (L/hr) - 491.3 445.2 299.8 330.7 * Epl.
- the study employed eight healthy male humans. Each subject received a single 100 mg oral dose of a solution of [ 14 C]eplerenone (specific activity 0.75 ⁇ Ci/mg). Plasma, saliva, breath, urine and fecal samples were collected at predetermined intervals and analyzed for sample radioactivity and the concentration of eplerenone and its open lactone ring form. Safety was determined on the basis of laboratory tests, vital signs, and the occurrence and types of adverse events.
- the subjects who underwent an overnight food fast prior to administration of the dose, received at 0800 hours a single 100 mg oral dose of an aqueous oral solution of radiolabeled eplerenone reconstituted in 80 mL of an apple juice/hydroxypropyl- ⁇ -cyclodextrin mixture.
- the subjects swallowed about 200 mL of water one, two and three hours post dosing.
- a 12-lead ECG was obtained prior to dosing (within one hour) and at 2, 3, 4 and 24 hours after administration of the study medication.
- Body temperature (oral), respiratory rate, and pulse rate and blood pressure (after sitting three minutes) were obtained prior to dosing (within one-half hour) and at 0.5, 1, 4, and 24 hours after administration (dosing) of the study medication.
- Blood samples were collected at -0.5 (predose), 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 16, 24, 36, 48, 72 and 96 hours post dose.
- Urine samples were collected for the following periods: -12 to 0; 0 to 2; 2 to 4; 4 to 8; 8 to 12; 12 to 24; 24 to 48; 72 to 96; 96 to 120; 120 to 144; and 144 to 168 hours. Individual fecal samples were collected beginning immediately after dosing and continuing through 0800 hours on day 8. In addition, one predose fecal sample was provided. Saliva samples were taken at 0.5 hour predose and at 0.5, 1, 2, 4, 6, 12, and 24 hours postdose. Breath samples were taken at 0.5 hour predose and at 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 and 72 hours postdose.
- the data show that elimination of eplerenone is by metabolism and not excretion of unchanged eplerenone.
- the mean percentages of the dose excreted as total radioactivity in urine and feces were 66.6% and 32.0%, respectively. The majority of urinary and fecal radioactivity was due to metabolites and less than 15% was due to eplerenone.
- the mean percentages of the dose excreted in urine as eplerenone and its open lactone ring form were 1.65% and 4.98%, respectively.
- the mean percentages of the dose excreted in feces as eplerenone and its open lactone ring form were 0.807% and 2.46%, respectively. There were no clinically significant changes in physical examinations, vital signs or clinical laboratory test results. There were no serious adverse effects.
- Table 25A Total Radioactivity Pharmacokinetic Parameter Plasma (+ SEM) Whole Blood (+ SEM) Saliva (+ SEM) AUC 0-inf (ng equivalents hr/mL) 18400 ⁇ 1200 12800 ⁇ 800 7960 ⁇ 500 C max (ng equivalents/mL) 2490 ⁇ 110 1770 ⁇ 80 2170 ⁇ 280 T max (hour) 1.3 ⁇ 0.2 1.1 ⁇ 0.2 0.6 ⁇ 0.1 Table 25B Plasma Concentration (ng/mL) Time After Dosing (hours) Eplerenone Open Lactone Ring Form -0.5 0 0 0.5 1345.0 63.2 1.0 1617.5 78.0 1.5 1591.3 70.8 2.0 1418.8 59.9 2.5 1258.1 51.0 3.0 1176.3 46.9 4.0 1001.4 41.9 6.0 595.5 23.0 8.0 390.6 13.0 12.0 148.6 1.9 16.0 68.0 0 24.0 17.3 0 3
- the bioavailability and safety of five different formulations were evaluated in an open-label, randomized, single dose, five-way crossover study of a group of healthy adult humans.
- the subjects received five single doses of 100 mg of eplerenone administered as (i) one eplerenone 100 mg immediate release (IR) capsule, (ii) one eplerenone 100 mg immediate release (IR) tablet, (iii) one eplerenone 100 mg controlled release (CR) tablet with a 50% in vitro dissolution time of two hours, (iv) one eplerenone 100 mg controlled release (CR) tablet with a 50% in vitro dissolution time of four hours, and (iv) one eplerenone 100 mg controlled release (R) tablet with a 50% in vitro dissolution time of six hours.
- Table 26A WEIGHT % OF TABLET/CAPSULE INGREDIENT IR Capsule (T.*A) IR Tablet (T. B) Two Hour CR Tablet 1 (T. C) Four Hour CR Tablet 2 (T. D) Six Hour CR Tablet 3 (T.
- the subjects who underwent an eight hour food fast and a one hour water fast prior to administration of each dose, received a single oral dose of one of the study medications on days 1, 8, 15, 22 and 29 in one of five randomized treatment sequences (ABDCE, BCAED, CDEAB, DECBA, and EABDC).
- the medication was administered together with about 180 mL of water at 0800 hours.
- Blood samples were collected at -0.5 (predose), 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours post dose.
- Urine samples were collected and pooled between the hours of 0-24 and 24-48 hours postdose.
- Analyses of the separated plasma and urine for eplerenone and its inactive open lactone ring form were performed at Phoenix International Life Sciences, Quebec, Canada.
- Plasma and urinary concentrations of eplerenone and its inactive open lactone ring form were determined using a validated high performance liquid chromatography ("HPLC") procedure for the inactive open lactone ring form.
- HPLC high performance liquid chromatography
- the lower limits of detection in urine were approximately 50 ng/mL for both eplerenone and the inactive form.
- Table 26F illustrates micronized eplerenone particle size distribution in microns for several of the preparations used in this Example.
- Subjects randomized to receive a high-fat breakfast were to completely ingest the meal within 20 minutes prior to dosing.
- the high-fat meal contained approximately 33 g protein, 75 g fat, 58 g carbohydrates and 1000 calories.
- Blood samples were collected at -0.5 (predose), 0.5, 1, 2, 3, 4, 6, 8, 12, 16, 24, 28, 32, 48 and 72 hours post dose and analyzed to determine the concentration of eplerenone and its open lactone ring form. There were no clinically significant changes in vital signs or physical examinations. All adverse events were mild in severity. The mean results are reported in Tables 27A and 27B below.
- the high-fat meal led to a reduction in C max and an increase in T max , but had minimal or no measurable effect upon AUC 0-96 and T 1/2 .
- the results indicate that the high fat meal had minimal effect on the extent of eplerenone absorption, but it did decrease the rate of absorption. Accordingly, dosing of eplerenone can be made without regard for meal time, as the effect of food appears to have minimal clinical significance.
- Eplerenone plasma concentrations were detectable at 24 hours postdose for all dosing groups. Plasma concentrations of eplerenone and mean dose-adjusted AUC values following either single or multiple doses indicate a lack of dose proportionality within the 100 mg to 1000 mg dosage range. Results for the open ring lactone form were consistent with dose proportionality following single or multiple doses. Overall, there was no significant or dose-related accumulation of either eplerenone or its open ring lactone form.
- the primary efficacy variable was the change in cuff diastolic blood pressure ( ⁇ DBP; sitting) measured at trough plasma levels after eight weeks of double blind treatment.
- the secondary variables measured were the change in trough cuff systolic blood pressure ( ⁇ SBP; sitting), change in 24 hour mean diastolic blood pressure ( ⁇ DBP), and change in 24 hour mean systolic'blood pressure ( ⁇ SBP).
- the primary and secondary efficacy variables were analyzed to compare BID versus QD dosing regimens for each eplerenone dose group, and both eplerenone and spironolactone versus placebo. Changes in plasma renin and serum aldosterone after eight weeks of dosing were also analyzed as secondary measures of efficacy.
- each eplerenone capsule is reported in Examples 5, 6, 7 and 8.
- the placebo was a conventional capsule containing lactose.
- the spironolactone used in the study was obtained from Searle Canada (Oakville, Ontario).
- An average increase in plasma renin concentration of about 10% or greater was observed over an interval of about 12 to 24 hours after administration of the study medication.
- An average increase in plasma aldosterone concentration of about 50% or greater was observed over an interval of about 12 to 24 hours after administration of the study medication.
- the dogs were fasted for 15 to 20 hours prior to administration of the capsule and were not fed again until at least 4 hours after dose administration.
- Blood samples (approximately 3 mL) were collected by venipuncture in chilled tubes containing heparin at 0, 0.5, 1, 2, 3, 4, 6, 8 and 24 hours after dose administration. The blood samples were immediately placed on ice. Separation of plasma from the blood samples was complete after about 15 minutes of centrifugation. The resulting plasma samples were frozen at about -20°C and stored until analyzed. Analysis was performed using an LC/MS/MS procedure.
- carrier material means material included in a pharmaceutical composition to impart certain desirable properties.
- carrier material can be added to moderate dissolution rate, mask a bad taste, or improve appearance of the tablet.
- matrix or “matrix system” means the combination of all carrier materials of a given formulation in which the active drug is incorporated.
- C max means the maximum observed concentration
- T max means the time at which C max occurred.
- T 1 ⁇ 2 means the terminal half-life, in units of hours, determined via simple linear regression of natural log (ln) concentration vs. time for data points in the 'terminal phase' of the concentration-time curve. T 1 ⁇ 2 was computed as - ln(2)/(- ⁇ ).
- AUC (0- ⁇ ) is calculated as AUC (0-LQC) + LQC/(- ⁇ ), where LQC was the last quantifiable plasma concentration and ⁇ is the slope from the calculation of T 1 ⁇ 2 .
- C max /AUC (0-LQC) means the rate of absorption.
- XU (0- ⁇ ) means the total amount of eplerenone (or inactive open lactone ring form of eplerenone ) in the urine during each collection period (0-24, 24-48 and 0-48 hours) calculated as the urine drug concentration multiplied by the urine volume.
- MRT is the mean resident time calculated as the area under the moment curve (AUMC (0-96) divided by AUC (0-96) .
- CL/F means the apparent (oral) clearance calculated as (1000 x dose in mg)/AUC (0-96) .
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| US11164698P | 1998-12-09 | 1998-12-09 | |
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| PCT/US1999/029136 WO2000033847A1 (en) | 1998-12-09 | 1999-12-08 | Micronized eplerenone compositions |
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| UA74141C2 (uk) * | 1998-12-09 | 2005-11-15 | Дж.Д. Сірл Енд Ко. | Фармацевтична композиція на основі тонкоподрібненого еплеренону (варіанти), спосіб її одержання та спосіб лікування розладів, опосередкованих альдостероном (варіанти) |
| ATE293977T1 (de) * | 1999-12-08 | 2005-05-15 | Pharmacia Corp | Nanopartikelzusammensetzungen enthaltend eplerenon |
| EP1527782A1 (en) * | 1999-12-08 | 2005-05-04 | Pharmacia Corporation | Nanoparticulate eplerenone compositions |
| JP2004501099A (ja) * | 2000-05-11 | 2004-01-15 | フアルマシア コーポレイション | アルドステロン頂点位相時の放出のためのアルドステロンアンタゴニスト組成物 |
| EP1303306B1 (en) * | 2000-07-27 | 2006-06-21 | Pharmacia Corporation | Epoxy-steroidal aldosterone antagonist and beta-adrenergic antagonist combination therapy for treatment of congestive heart failure |
| AU2001280804A1 (en) * | 2000-07-27 | 2002-02-13 | Eileen R. Blasi | Aldosterone blocker therapy to prevent or treat inflammation-related disorders |
| DK1313485T3 (da) * | 2000-08-28 | 2005-12-27 | Pharmacia Corp | Anvendelse af en aldosteronreceptorantagonist til forbedring af kognitiv funktion |
| US8168616B1 (en) * | 2000-11-17 | 2012-05-01 | Novartis Ag | Combination comprising a renin inhibitor and an angiotensin receptor inhibitor for hypertension |
| IL157816A0 (en) | 2001-03-12 | 2004-03-28 | Roberto Pellicciari | Steroids as agonists for fxr |
| US20040173146A1 (en) * | 2001-06-07 | 2004-09-09 | Figueroa Iddys D. | Application of a bioactive agent to a delivery substrate |
| US20040173147A1 (en) * | 2001-06-07 | 2004-09-09 | Figueroa Iddys D. | Application of a bioactive agent to a delivery substrate |
| US6962715B2 (en) * | 2001-10-24 | 2005-11-08 | Hewlett-Packard Development Company, L.P. | Method and dosage form for dispensing a bioactive substance |
| GB0114532D0 (en) * | 2001-06-14 | 2001-08-08 | Jagotec Ag | Novel compositions |
| KR20040023660A (ko) * | 2001-07-19 | 2004-03-18 | 파마시아 코포레이션 | 알도스테론 수용체 길항제 및 hmg coa 환원효소억제제의 병용물 |
| KR20040071723A (ko) * | 2001-12-13 | 2004-08-12 | 파마시아 코포레이션 | 에폭시-스테로이드 알도스테론 길항제를 사용하는 대상의알도스테론-매개 병원성 효과의 치료 또는 예방 방법 |
| CN1625412A (zh) * | 2002-01-30 | 2005-06-08 | 法玛西雅公司 | 预防或治疗心血管疾病的醛甾酮拮抗剂和非-甾族抗炎剂的组合疗法 |
| CN1326569C (zh) * | 2002-02-26 | 2007-07-18 | 阿斯特拉曾尼卡有限公司 | 含有水溶性纤维素衍生物的iressa药物制剂 |
| JP2005520856A (ja) * | 2002-03-20 | 2005-07-14 | ファルマシア コーポレーション | 貯蔵時に安定なエプレレノン製剤 |
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